CONTRACT FOR HEALTH SERVICES
Kotka Erahaigla AS, registry code 12895108 (‘Clinic’), e-mail: email@example.com, telephone: +372 653 0777, represented by Jüri Kullamaa;______________ , ID code/date of birth ______________ (‘Patient’) have entered into this contract (‘Contract’) on the following conditions ______________ (date):
1. GENERAL PROVISIONS
The Clinic offers to the Patient under the Contract plastic and reconstructive surgery services. The services may cover both, non-surgical procedures as well as major surgical operations and may require induction of anaesthesia.
If the Patient, to whom the service is provided, is with restricted active legal capacity, the fulfilment of his or her contractual obligations shall be the responsibility of his or her representative, who signed the Contract.
2. PROVISION OF THE SERVICE
Provision of the service starts from a consultation between the Patient and the Clinic, in the course of which the Patient shall explain to the Clinic his or her goals and the desired outcome and the Clinic will introduce to the Patient the possibilities of satisfying the Patients’ wishes.
The exact extent of the service to be provided to the Patient shall be agreed upon and the treatment plan (Annex 1) will be established during the consultation. Also, the Clinic shall provide the Patient with a price estimate based on the price list published on the website of the Clinic, on the agreed services and their scope.
When preparing the treatment plan and providing the service to the Patient, the Clinic shall consider the wishes of the Patient and the general state of health and shall select based on that the most suitable procedures for the Patient. Depending on the requested service, the Clinic may refer the Patient to medical examination.
The Clinic will give a detailed explanation to the Patient of the content and nature of procedures included in the treatment plan and any potential risks and consequences involved. The Clinic will explain to the Patient what to do to prepare themselves for the procedures and to recover from these, including, what are the necessary restrictions to living arrangements before and after providing the service. The respective information has been presented to the Patient also in writing (Annex 1).
For the procedures foreseen in the treatment plan, the Patient shall appear at the Clinic at the agreed times and follow the instructions of the Clinic when preparing for and recovering from the procedures.
The Patient is aware that it is not always possible to achieve a perfect outcome, primarily a result that corresponds to the imagination of the Patient in an aesthetically ideal way and that the Clinic cannot guarantee this.
3. PATIENT`S OBLIGATIONS UPON INDUCTION OF ANAESTHESIA
If anaesthesia is planned for the Patient, the Patient shall inform the Clinic in order to mitigate the involved risks, whether the Patient:
suffers from chronic diseases (such as hypertension, asthma, diabetes, etc.);
is allergic to painkillers;
smokes, uses alcohol or drugs.
The Patient shall inform the Clinic if he or she uses medication on a daily basis. The Patient must continue taking the medicine as usual until the day when a procedure requiring the anaesthesia will take place, unless the Clinic provides different instructions.
The Patient shall inform the Clinic if he or she takes aspirin or other blood thinners. The Clinic may prohibit the Patient from using blood thinners within two weeks before the surgery.
In case of general anaesthesia, the Patient must inform the Clinic of loose teeth and dentures.
In the event of general anaesthesia, the Patient is not allowed to eat or drink in the morning of the day of surgery, unless otherwise told by the anaesthesiologist of the Clinic!
4. RIGHTS AND OBLIGATIONS OF THE PARTIES
The Clinic provides the Patient the service with the care which can normally be expected of providers of health care services and shall ensure that the service conforms at least to the general level of medical science.
During the service, the Clinic shall assess the Patient’s state of health and suitability for providing the service. The Clinic shall inform the Patient of the results of examination and the conducted health checks, including of any possible identified illnesses and their course.
To ensure safety of the Patient and achieve the best possible results, the Patient shall disclose truthfully to the Clinic the entire necessary information, which may be relevant to the provision of the service, including true and complete information on his or her state of health, previously provided treatments and used medicines.
The Patient shall provide all possible assistance to the Clinic during the service. Above all, the Patient shall follow the directions and instructions given by the employees of the Clinic.
In case there are complications after providing the service, the Patient shall be required to immediately turn to the Clinic, to establish whether the complications are related to the provided service and whether the Patient needs further treatment or the procedure to be repeated.
The Clinic shall document the provision of the service and shall store the documents pursuant to the established procedure. In cases arising from law, the information shall be forwarded to the health information system or other registers.
The Patient shall pay a fee for the provided service.
Payment for the service shall be made as an advance payment on the day of providing the service, at the latest, unless otherwise agreed in writing by the Clinic and the Patient.
Upon request, the Patient may apply for hire purchase from credit institutions via the Clinic. The Patient may inquire information on the application procedure of hire purchase from the Clinic.
The Patient is aware that Estonian Health Insurance Fund does not compensate for the amounts payable for the services.
6. LIABILITY FOR THE VIOLATION OF THE CONTACT
The Clinic shall be liable under the law for culpable violation of its obligations, above all, for diagnosis and medication errors.
The Clinic shall not be liable for the occurrence of damages, if this is caused by violation of the obligation to provide information or assistance by the Patient, including, if the Patient fails to follow the Clinic’s instructions for preparing for or recovering from the treatment procedures.
The Patient is aware that it is not always possible to achieve a result that corresponds to the imagination of the Patient in an aesthetically ideal way and that the Clinic cannot guarantee this.
Accordingly, the fact that according to the Patient, the result is not suitable, is not aesthetic or does not correspond to the expectations, does not serve as grounds to a claim for damages or repayment of the money.
Claims against the Clinic may be filed only if the experts of the field have established that the Clinic has made a medical error when providing the service to the Patient.
If the Patient fails to appear at the Clinic at the agreed time to receive the procedure and does not inform the Clinic thereof by e-mail or by phone more than 24 hours in advance or, if the service cannot be provided for other reasons attributable to the Patient (e.g. failure to follow the instructions of the Clinic), the Clinic shall have the right to demand a payment of 30% of the price of the procedure that was not carried out.
7. PRIVACY AND PERSONAL DATA PROTECTION
The Clinic shall keep confidential the data learned by the Clinic on the Patient and his or her health.
The Clinic is the controller of the Patient’s personal data. The Clinic gathers and processes the Patient’s personal data, including health data, for the performance of the Contract, i.e. within the extent which is necessary for providing the service and documenting thereof. A more detailed information on how the Clinic processes the Patient’s personal data and on the Patient’s rights has been enclosed to the Contract (Annex 2).
The Patient can designate the persons, to whom the Clinic is entitled to issue information on the Patient’s health (Annex 1).
8. VALIDITY, TERMINATION AND CANCELLATION OF THE CONTRACT
The Contract expires with completing the provision of the services specified in the treatment plan. The Patient may unilaterally terminate the Contract at any time by a written notice. With good reason, the Clinic may terminate the Contract unilaterally by a written notice also earlier, unless it will result in an immediate risk for the Patient’s health.
A good reason, in which case the Clinic may terminate the Contract and refuse to provide further services, constitutes above all the situations where the Patient himself or herself prevents the work of the Clinic and the provision of the service; for example when:
The Patient fails to comply with the instructions and orders given by the Clinic;
The Patient violates the obligation to provide information or there is a reason to assume that the Patient has provided false information;
The Patient has on two or more occasions failed to appear at the scheduled consultation or procedure with less than a 24h notice or without any notice;
The Patient delays the payment for the service.
If the Contract ends before the treatment plan is completed, the Patient has a right to get oral explanations from the Clinic on the services already provided to the Patient and on the potential consequences of discontinuation of the treatment plan and on the further need for health services.
Termination of the Contract shall not release the Patient of the obligation to pay for the services provided under the Contract or for the preparations made for their provision.
9. FINAL PROVISIONS
The parties shall forward notices relating to the Contract by e-mail or phone.
Any disputes, arising from the Contract, shall be resolved by agreement of the parties. If an agreement is not reached, the dispute shall be resolved by Harju District Court. In order to receive an extrajudicial opinion about the quality of the health services, the Patient may, as an alternative, turn to the expert committee on the quality of health care at Ministry of Social Affairs, Suur-Ameerika 1, 10122 Tallinn or by e-mail at firstname.lastname@example.org.
The Contract has the following annexes
Annex 1 – Notification of the Patient and consent
Annex 2 – Terms and conditions for processing the Patient’s personal data