Patient Personal Information

Helderberg Hospice – Patient Personal Information

By providing Helderberg Hospice with your personal information and documentation, as set out herein, you voluntarily consent to it being reasonably retained, stored and processed. Your further acknowledge that such information is retained and processed for the lawful purposes and objectives of the organisation and that the information may be retained in a database to allow the organisation to communicate with you in future regarding prospective objectives / donations / interests. Such personal information will remain confidential and will not be shared with any third parties without your consent. All reasonable measures will be taken to safeguard your personal information. Should you object to our retention and processing of your personal information or should you wish to rectify your personal information retained with us, kindly inform us via e-mail at data@helderberghospice.org.za

Other Form To Complete: PATIENT MEDICAL REFERRAL