Online Physiotherapy Advisory Services Consent Form
Introduction:
This consent form is designed to inform you about the online physiotherapy advisory services provided by Ana Paula Baena Q. and to obtain your agreement to participate under the terms outlined below. By using our services, you acknowledge and agree to the following terms.
Nature of Services:
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Advisory Only:
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The services provided are solely advisory in nature. They do not constitute medical treatment or therapy and are not intended to replace a comprehensive in-person evaluation and treatment by a licensed physiotherapist.
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Any advice or recommendations given are based on the information you provide and are meant for general guidance. They are not guaranteed to be accurate, effective, or suitable for every individual.
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No Doctor-Patient Relationship:
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Using our online advisory services does not create a doctor-patient relationship between you and Ana Paula Baena Q.
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You should always consult with your primary healthcare provider before making any changes to your health or exercise regimen.
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Limitations and Risks:
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Not a Substitute for In-Person Care:
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The advisory services are not a substitute for an in-person consultation with a licensed physiotherapist.
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You should not delay seeking medical advice or disregard professional medical advice based on information obtained through our services.
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Potential Risks:
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There are potential risks associated with following any exercise or treatment advice without in-person supervision, including but not limited to injury or worsening of your condition.
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Legal Protection:
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No Liability:
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Ana Paula Baena Q. is not liable for any injuries, damages, or adverse outcomes that may result from following the advisory services provided.
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By using our services, you agree to release and hold harmless Ana Paula Baena Q. from any and all claims or causes of action arising from your use of the services.
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Jurisdiction:
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This agreement shall be governed by and construed in accordance with the laws of the State of Texas, United States. Any disputes arising from this agreement shall be resolved exclusively in the state or federal courts located in Dallas, Texas.
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Acknowledgment and Agreement:
By checking the box indicating acceptance of the terms and conditions, you acknowledge that you have read, understood, and agree to the terms outlined in this consent form. You also agree that you are using the services at your own risk and that you will not hold Ana Paula Baena Q. liable for any outcomes resulting from the use of these services.
Privacy Notice
Please read our privacy notice before scheduling an appointment.
Privacy Notice
Privacy Notice
We are committed to protecting your personal data. This privacy notice outlines how we collect, use, and protect your information in compliance with Texas state law and federal law.
Data Controller
The data controller responsible for your personal data is Ft Ana Paula Baena Q, located in Dallas, Texas. For any questions related to the processing and protection of your personal data, please contact us at info@ftanapaulabaenaq.com.
Personal Data Collected
We may collect the following personal data:
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Full name
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Email address
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Phone number
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Information about your health status and relevant medical history (only if necessary for the advisory services provided)
Purpose of Data Processing
Your personal data will be used for the following purposes:
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To provide the physiotherapy advisory services you have requested.
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To contact you with information related to our services.
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To send newsletters, promotions, and other health-related materials (if you have given your express consent to receive these).
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To improve the quality of our services and your experience as a user.
Sharing of Personal Data
Your personal data will not be shared with third parties without your consent, except as required by law or when necessary to comply with legal obligations.
Your Rights
Under Texas state law and federal law, you have the following rights regarding your personal data:
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Access: You have the right to request access to your personal data.
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Rectification: You have the right to request correction of inaccurate or incomplete data.
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Deletion: You have the right to request the deletion of your personal data, subject to certain legal exceptions.
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Objection: You have the right to object to the processing of your personal data under certain circumstances.
To exercise these rights, please submit a written request to info@ftanapaulabaenaq.com including your full name, contact details, and a description of your request.
Security Measures
We implement appropriate technical and organizational measures to protect your personal data against unauthorized access, loss, alteration, or destruction.
Changes to this Privacy Notice
We may update this privacy notice from time to time to reflect changes in our practices or legal requirements. Any updates will be posted on our website at www.ftanapaulabaenaq.com. We encourage you to review this privacy notice periodically to stay informed about how we are protecting your data.
Consent
By providing your personal data, you acknowledge that you have read and understood this privacy notice and consent to the processing of your personal data as described herein.
Contact Information
If you have any questions or concerns about this privacy notice or our data processing practices, please contact us at:
Email: info@ftanapaulabaenaq.com
Address: [Insert Address Here], Dallas, Texas
Date of Last Update: July 11, 2024