Pursuant to the Law on Personal Data Protection No. 91/2025/QH15 effective from 01/01/2026 and related legal regulations, Phòng khám Gia đình Đà Nẵng — Chi nhánh Công ty Cổ phần Phòng khám Gia đình Thành phố Hồ Chí Minh (Da Nang Family Medical Practice — Branch of Ho Chi Minh City Family Medical Practice Joint Stock Company) ("FMP") is committed to protecting the privacy, confidentiality and security of patients' personal data, including sensitive personal data related to health. I confirm that the information I have provided, am providing or will provide to FMP is lawful, accurate, complete and up to date at the time of provision.
(I) Basic personal data including but not limited to: full name; date of birth; gender; nationality; passport/ID number; contact address; phone number, email; emergency contact information; insurance information; appointment information; payment and invoice information.
(II) Sensitive personal data including but not limited to: medical records and clinical notes; diagnoses and treatment plans; prescriptions and medical orders; test results and diagnostic imaging; vaccination records; medical history and health status; emergency records.
FMP may collect data directly from the patient or indirectly from legal representatives, insurance companies, medical facilities, or third parties in accordance with the law. FMP is committed to collecting only personal data that is necessary, appropriate and limited to the scope of lawful processing purposes.
By signing this document and/or using FMP's services, I consent to FMP collecting, using, storing, processing and sharing my personal data for the following purposes: verifying the identity and accuracy of patient information; medical consultation, diagnosis, treatment, care and follow-up; managing appointments, medical records and administrative procedures; invoicing, payment and debt processing; verifying insurance benefits, performing guarantee, payment or reimbursement procedures; coordinating with medical facilities, laboratories or specialized units serving medical examination and treatment; ensuring service quality, internal operations management and complaint resolution; fulfilling legal obligations, reporting obligations and requests of competent state authorities; responding to emergencies or protecting the life and health of the patient or other individuals; other lawful purposes as prescribed by law.
I agree that FMP may share or transfer my personal data to the extent necessary and consistent with the processing purposes to the following parties: clinics and affiliated companies of the Family Medical Practice Group; domestic and international insurance companies; laboratories, referral hospitals, emergency units, airlines or related medical service providers; providers of information technology, data storage, accounting, auditing or professional consulting services; competent state authorities as required by law; the patient's workplace (where the company pays the costs). FMP requires data recipients to fulfill confidentiality and information security obligations and to process personal data only for permitted purposes.
In certain cases necessary for the provision of medical services, system management or international insurance processing, my personal data may be transferred to or accessed from outside the territory of Vietnam. FMP commits that the transfer of personal data abroad will be carried out in accordance with Vietnamese law, including the application of appropriate protection and security measures.
FMP applies appropriate technical, managerial and security measures to protect personal data from the risk of unauthorized access, loss, disclosure, modification or inappropriate use, in accordance with legal regulations on personal data protection, information technology and medical examination and treatment.
I have the rights to: be informed about data processing activities; access and request copies of data; request correction or updating of data; withdraw consent to the extent permitted by law; request restriction of processing or deletion of data; complain, denounce or claim compensation in accordance with the law.
Requests may be sent to FMP at: Phòng khám Gia đình Đà Nẵng — Chi nhánh Công ty Cổ phần Phòng khám Gia đình Thành phố Hồ Chí Minh (Da Nang Family Medical Practice — Branch of Ho Chi Minh City Family Medical Practice Joint Stock Company), Address: 96-98 đường Nguyễn Văn Linh, Phường Hải Châu, TP. Đà Nẵng (96-98 Nguyen Van Linh Street, Hai Chau Ward, Da Nang City).
By ticking the consent boxes below and submitting this form, I confirm that I have read, understood and agree to the entire content of this Notice. The consent is effective from the date of submission until I send a written request to FMP to amend or withdraw it.