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Personal Data Processing Model Consent Form

  1. I have been provided with the Skearth Healthcare Pvt. Ltd. ( "5eCare" ) Privacy Policy and Privacy Notice, which are also available on https://uhi.abdm.gov.in/documents/ABDM_Health_Records_PHR_mobile_application_privacy_policy , and have understood the contents thereof.

  2. I understand that the Privacy Notice and Privacy Policy mentioned in Paragraph 1 above provide information about how my personal data may be collected, used and disclosed by Skearth Healthcare Pvt. Ltd. ( "5eCare" ) or the NDHM or its ecosystem partners across the National Digital Health Ecosystem.

  3. I understand that my personal data may be collected only with my valid consent, and that it may be used or processed only in accordance with the NDHM Health Data Management Policy notified by the NDHM, and the Privacy Policy and Privacy Notice issued by Skearth Healthcare Pvt. Ltd. ( "5eCare" )

  4. I understand that my personal data may be shared across various entities within the National Digital Health Ecosystem only with my consent, and for the following purposes:

    • Facilitation of Healthcare Services: To enable secure sharing of medical records with healthcare providers for diagnosis, treatment, and follow-up care.

    • Appointments and Consultations: To facilitate booking and managing appointments with doctors, hospitals, and healthcare professionals.

    • Health Record Management: To allow storage, retrieval, and management of my health records, ensuring easy access and continuity of care.

    • Health Monitoring and Analysis: To analyze my health data for tracking body vitals, monitoring progress, and generating insights for improved well-being.

    • Personalized Health Recommendations: To provide tailored health advice, reminders, and recommendations based on my medical history and current health data.

    • Insurance and Claims Processing: To assist with insurance claims, verification, and processing of health-related policies, where applicable.

    • Research and Policy Improvement: To contribute anonymized and aggregated data for public health research and to enhance healthcare policies, while ensuring data privacy.

    • Integration with National Health Programs: To facilitate services under government health initiatives and schemes, ensuring the benefit of government-supported healthcare programs.

    • Data Analytics for Health Outcomes: To process health data for generating insights, improving healthcare delivery, and measuring the efficacy of treatment plans.

  5. I understand that I have certain rights that I enjoy as a data principal over my personal data, in relation to its collection, use and processing. These rights relate to confirmation and access, correction and erasure, objection of disclosure, and portability of my personal data. These rights are available to me in the manner set out in the NDHM Health Data Management Policy notified by the NDHM and the Privacy Policy and Privacy Notice issued by Skearth Healthcare Pvt. Ltd. ( "5eCare" )

  6. I understand that the terms of the Privacy Notice may change, and I will be notified of the same before or at the time any further collection, use or processing of my personal data takes place. I understand that I will be provided the opportunity to provide fresh consent for the same.

  7. I understand that I have the right to revoke my consent at any time in the manner specified under the Privacy Notice, and such revocation will not result in penalty or loss of benefits to which I am otherwise entitled by the Central and respective State Government or any healthcare providers.

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Having read and understood the points mentioned above, I consent to allowing Skearth Healthcare Pvt. Ltd. ( "5eCare" )  to collect, use, share or process such personal data as may be necessary to provide health services availed by me.

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I understand and agree to [insert data fiduciary name] providing these health services in a manner that is in accordance with the NDHM Health Data Management Policy, the [data fiduciary] Privacy Policy and Privacy Notice, any information security policy, data archival and retention guidelines, any other policy that may be notified from time to time for the implementation of these abovementioned policies, and any other law that may be applicable.

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Consent Electronically Captured​

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