Information consent and indemnity
You hereby grant your health practitioner and/or their authorised employees/ agent(s), the consent to share copies of and/or information about your medical/health records in relation to the new POPIA act.
You understand that the said medical/health records may include but are not limited to hand-written notes, notes taken by previous practitioners, typed summary, referral letters to and from other health care practitioners, laboratory reports/ evidence, audio-visual records, clinical research forms, clinical trial data and other forms completed or information or evidence obtained during the above practitioner’s health interaction, consultation or examination process with you as their patient.
You confirm that you have legal capacity to give this consent/ Or give consent on behalf of a minor as their parent or guardian.
You Agree to the use of information obtained during your treatments to be used for research, with your identity remaining confidential.
In the case that you see a Physio Therapist and/or Biokineticist and/or Pilates Instructor and/or Sports Massage therapist who work under the name of Beyond Performance, you give consent for your information to be shared between professionals, in order to optimise your treatments.
You expressly assume all risks of taking part in any of the treatments, sessions or classes offered at Beyond Performance by the various professions as well as all risks that may lead to damage or loss on premises during that treatment/session/class.
You affirm that any medical condition or injury that will affect the quality and safety of the treatment/session/class will be communicated to the practitioner, and this practitioner shall not be held liable should you forget to do so.