General Consent Form

1. General Consent

I the patient/patient’s next of kin, hereby agree to such general diagnostic procedures and treatments as are necessary and appropriate for my condition or illness in the Medical Centre judgment of my Doctor(s), to be performed by the Medical Centre, Doctors, Nurses, and other health care providers.

2. Financial Consent

I understand that expenses may vary according to the treatment offered. I, the undersigned, take full responsibility to pay all expenses that may originate from my (or the patient’s if I am the guardian) staying and treatment in the Medical Centre which the insurer may not cover.

I have been shown and have had the opportunity to review the charges which may be applicable to me (or the patient, if I am the guardian) and have had them explained to me by the appropriate Medical Centre staff.

3. Personal Belongings

I acknowledge that the Medical Centre and any of its staff are not liable for any loss or damage that may occur to any of my belongings that I have brought with me to the clinic unless received and signed for by the Medical Centre’s staff.

4. Use of this Consent Form

I understand that this form can be used as legal evidence in a court of law or other proceedings as evidence of the matters I have acknowledged or agreed to above, including consent for general treatment and financial responsibility in the case of non-payment of my expenses for treatment provided by the Medical Centre.

5. Patients’ Rights and Responsibilities

I am aware of the Patient’s Rights & Responsibilities.

6. NABIDH Health Record Access

I agree that healthcare provider(s) involved in my care at this facility will access my health information through the Health Information Exchange System (NABIDH) in accordance with the laws of the United Arab Emirates, Emirates of Dubai legislation and Dubai Health Authority policies.