Consent Form For Data Processing

CONSENT FORM FOR DATA PROCESSING

In Compliance with the Data Privacy Act of 2012 (Republic Act No. 10173)

We value your privacy and are committed to protecting your personal data.

By signing this consent form, you acknowledge and agree to the collection, use, processing, and sharing of your personal data in accordance with the Data Privacy Act of 2012 and the terms outlined below.

1. Data Collection Purpose

We collect personal data for the following purposes:

•Patients: To provide healthcare services, maintain medical records, and process billing information.

•Doctors and Medical Staff: For credentialing, internal communication, work allocation, and compliance with regulatory requirements.

•Administrative Staff: To manage employment records, payroll, benefits, and internal communication.

•Interns and Internship Coordinators: To monitor internship programs, document performance, and ensure compliance with training protocols.

2. Types of Data Collected

We may collect the following types of data:

•Personal Identification Data: Full name, contact information, date of birth, address, and identification numbers (e.g., SSS, TIN, or PRC numbers).

•Health-Related Data (for patients): Medical history, treatment records, laboratory results, diagnostic imaging, and other relevant health information.

•Employment or Internship-Related Data (for doctors, staff, interns): Job position, educational background, professional qualifications, work schedule, performance evaluations, and attendance records.

•Sensitive Data: Data related to health, race, ethnic origin, religious beliefs, or any other information categorized as sensitive by law.

3. Data Use

Your data will be used only for the following purposes:

•Patients: To facilitate healthcare services, medical documentation, and regulatory compliance.

•Doctors and Administrative Staff: For employment-related purposes such as compensation, benefits, training, and compliance.

•Interns and Internship Coordinators: To track internship progress, academic compliance, and training requirements.

Your personal data will not be used for any other purpose unless with your consent or as required by law.

4. Data Storage and Retention

Your data will be stored securely in our systems for as long as it is necessary or within 5 Years to fulfill the above purposes or as required by applicable laws and regulations. After this period, data will be securely destroyed or anonymized.

5. Data Sharing and DisclosureWe may share your data with:

•Healthcare professionals involved in your care (for patients).

•Authorized government agencies as required by law.

•Partners and third-party service providers under strict confidentiality agreements for the purposes mentioned above. No personal data will be shared with unauthorized third parties without your explicit consent.

6. Rights of Data Subjects

Under the Data Privacy Act, you have the following rights:

•Right to be informed: You have the right to know how your data is being processed.

•Right to access: You may request access to your personal data and information about how it is processed.

•Right to correct: You may request corrections to any inaccurate or incomplete data.

•Right to object: You may object to the processing of your data under certain conditions.

•Right to erasure: You may request the deletion of your personal data when it is no longer necessary for the purposes stated.

•Right to file a complaint: You may lodge a complaint with the National Privacy Commission if you believe your data privacy rights have been violated.

7. Consent

By submitting this form, you acknowledge that you have read and understood this consent form and agree to the collection, use, processing, storage, and sharing of your personal data as described above.