DR ZINZI LIMBA'S

Information Consent Form

    Information Consent

    Privacy Notice

    Doctor Zinzi Limba Inc would like all patrons to be familiar with how we collect, use and disclose patients’ personal information prior to them procuring our services. Should you consent to our privacy notice below, we will use your personal information in an array of measures for the benefit of your treatment needs. We will use your personal information to manage our relationship with you and, by your allowances, provide you with information that is best suited to your medical need. We may also use your personal information to compile statistical data. Your personal information will be shared with our affiliate service providers and as described in our privacy notice; your personal information will be transferred to other doctors.

    Information collection

    Dr Zinzi Limba Inc has employed an array of messures to collect your data and personal information. These are, and are not limited to; i) questionaires, ii) online forms, iii) interviews and iv) written medical forms. We may also extract your information and data from known associates such as; i) your general practitioner, ii) your referring physician, and iii) other referring medical personel.

    Dr Zinzi Limba Inc will use the personal information and data extracted, for administrative and medical purposes to manage our relationship with you, to formulate a treatment response as per your medical requirements. We may also use your personal information to compile statistical data on our databases, as well as keep record of customer service feedback through questionnaires and similar communications to manage our relationship with you more effectively and provide you with information tailored to your needs. We will use your information to create a profile of new.

    Dr Zinzi Limba Inc will provide a personalised experience that is more relevant to your needs, interests and preferences. Patients’ files will be used to; (i) access the correct compensation for procured services and, (ii) identify a specialist suitable for patients based on a fair market calculation and the treatment required and patients’ individual needs, interests and preferences.

    Disclosure of information

    The disclosure of patient’s information will occur under monitored circumstances and are only for the benefit of the patient. These circumstances are, and are not limited to; (i) referral letters, (ii) medical reports, and (iii) feedback letters to referring medical personel. These are the circumstances in which patients information may be disclosed to affiliates and for purposes stated above.

    Your privacy rights

    You reserve the right to request to review the personal information we have collected about yourself as a patron of Dr Zinzi Limba INC as well as the right to request correction deletion, objection, and restriction, of our use of such information. You can make a request or withdraw your consent to receive marketing communications from
    us by contacting us through this web form. Should you feel your privacy right has been breached you may contact HPCSA.

    Data Retention

    We will retain your personal information for as long as needed or permitted in the light of the purposes for which it was obtained. The criteria used to determine our retention periods include (i) the length of time we have an ongoing relationship with you and provide the service to you; (ii) whether there is a legal obligation to which we are subject and; (iii) whether attention is advisable considering our legal position such as regarding applicable statutes of limitations litigation or regulatory investigations.

    Patient Name

    Date

    Signature

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