Virtual Consent Form

• I authorise Sampax Health to use appropriate virtual and telecommunication technologies for the purpose of evaluating and diagnosing my medical condition and any health complaints.
• I understand that technical issues may arise before or during virtual or telehealth sessions and, on occasion, my appointments may not start or end at agreed-upon times.
• I accept that medical professionals will attempt to contact me using video conferencing software. However, I also understand that other communication channels, such as telephone calls, may be used in case of internet connectivity or other issues.
• I understand that my medical aid may not encompass telehealth services. In the case where my medical aid does not cover any expenses which have been incurred, I will be personally liable to cover these expenses.
• I give Sampax Health permission to access my medical records for the purpose of ongoing documentation, evaluation, and analysis. I understand that all confidential information will be kept private.