Patient's consent to teleconsultation, electronic prescription and documentation management

I, the undersigned, declare that:
1. I consent to the provision of medical services through teleconsultation.

2. I was informed of the limitations associated with the lack of physical examination.

3. I undertake to provide truthful and complete information about my health status.

4. I recognize that a doctor may refuse to issue a prescription or document if this is not medically justified.

5. I consent to the processing of my personal data for the purpose of providing medical services.

, I give my consent

CONSENT TO THE ISSUANCE OF ELECTRONIC PRESCRIPTIONS AND DOCUMENTATION

I give my consent to:
1. An electronic prescription based on an online consultation.

2. An extract of an electronic coupon for medical care (if it is medically justified).

3. Maintaining and storing medical records in electronic form. 4. Data transfer to medical systems (for example, P1, e-Health).

☐ I agree