Patient Waiver and Release of Liability

PATIENT WAIVER AND RELEASE OF LIABILITY
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READ THE FOLLOWING PATIENT WAIVER AND RELEASE OF LIABILITY PRIOR TO SIGNING; EXECUTION OF THIS DOCUMENT AFFECTS YOUR RIGHTS.

  1. Facilitator is in the business of facilitating travel for people seeking medical treatment internationally (“Facilitator’s Services”).
  2. Facilitator’s Services do not include medical advice, guidance, treatment, therapy, prescribing of medications, or any other health, medical or therapeutic services of any kind (“Medical Services” or “Medical Procedures”).
  3. Facilitator’s personnel and representatives are not medical professionals and are not qualified to provide Medical Services of any kind. Any medical professionals engaged by Participant are not employed by or representatives of Facilitator.
  4. Information provided by Facilitator is for educational purposes only. Participant is encouraged to consult with medical professionals of their choosing regarding Medical Procedures. Participant understands the importance of consulting with trusted, independent medical professionals before traveling to receive, or engaging in Medical Procedures.
  5. Participant acknowledges and agrees that Facilitator has not (i) provided health or medical advice, guidance, or services; (ii) evaluated or opined on Participant’s health for any purpose, including for travel or engaging in Medical Services; or (iii) recommended, endorsed, warranted, or guaranteed any Medical Procedures or medical treatment providers.
  6. Facilitator’s Services may include collection of money for payment to medical providers. Such services are not an endorsement of any Medical Services or medical treatment providers.
  7. Participant understands and accepts that all Medical Procedures may involve serious risks including injury and/or death and such risks are inherent and cannot be eliminated or completely avoided through exercise of any degree of diligence or care.
  8. Participant further understands and accepts that traveling to jurisdictions outside of the USA and Canada or any other country of residence also involves serious risks which are inherent and cannot be eliminated through the exercise of any degree of diligence or care.
  9. Participant understands complications arising from Medical Procedures may result in additional expenses, costs, and/or charges for which Participant will have sole financial responsibility. Participant grants Facilitator the authority to cover such additional charges using the credit card Participant has provided to and is on file with Facilitator.
  10. Participant understands that the diagnosis made during the evaluation process based on the photos received by the participant as well as the proposed surgeries/proceedures is/are subject to be changed upon the result of clinical examination in the hospital and that any additional costs decided by the physcian will be borne by the participant in advance.
  11. Participant understands medical provider may refuse treatment for any reason including based on their professional medical opinion of Participant’s health. Participant understands Facilitator has no control or influence over any such decision.
  12. Participant will travel to ISTANBUL, TÜRKYIE or any other state/city in Türkyie for Medical Treatment/Procedure as described in the treatment plan originally submitted to the participant. Participant acknowledges that the travel and Medical Procedures undertaken are taken of their own free will, after due consideration, and at Participant’s sole risk.
THEREFORE, in full understanding of the acknowledgements contained herein and after due consideration, I hereby:
Participant Full Name
Signature
Printed Name
Date
Witness Full Name
Signature
Printed Name
Date