Consent Form test – Healthcare Abroad

Please enter your details, as they appear on your passport.

By completing this form you (the patient) consent to being contacted by Healthcare Abroad by the methods you choose.

A copy of your medical data will be securely stored by Healthcare Abroad and this form is to record your consent being given.

If you wish to withdraw this consent at any point, please contact us.

Click Here to see Zed Doctor Platform Info.

Click Here to see Privacy Policy.

Click Here to see Terms of Use.

Please read & tick the consent policy below:

I consent to allow Healthcare Abroad to share Records and Data with other hospitals
within the Healthcare Abroad network of hospitals.

I consent to have a Zed account created so that my medical images and documents
can be made available to receiving hospitals and Healthcare Abroad for 12
months. More information about our policy is located here.

I have read and agree to the Privacy policy and Terms of Use.

I consent to allow Healthcare Abroad to discuss my treatment plan with my GP.

I consent to allow Healthcare Abroad to contact my Credit Union, if required.

I consent to allow Healthcare Abroad to contact me by phone, email and SMS.

Click here to take survey

Cookie	Duration	Description
cookielawinfo-checkbox-analytics	11 months	This cookie is set by GDPR Cookie Consent plugin. The cookie is used to store the user consent for the cookies in the category "Analytics".
cookielawinfo-checkbox-functional	11 months	The cookie is set by GDPR cookie consent to record the user consent for the cookies in the category "Functional".
cookielawinfo-checkbox-necessary	11 months	This cookie is set by GDPR Cookie Consent plugin. The cookies is used to store the user consent for the cookies in the category "Necessary".
cookielawinfo-checkbox-others	11 months	This cookie is set by GDPR Cookie Consent plugin. The cookie is used to store the user consent for the cookies in the category "Other.
cookielawinfo-checkbox-performance	11 months	This cookie is set by GDPR Cookie Consent plugin. The cookie is used to store the user consent for the cookies in the category "Performance".
viewed_cookie_policy	11 months	The cookie is set by the GDPR Cookie Consent plugin and is used to store whether or not user has consented to the use of cookies. It does not store any personal data.