HEALTH TOURISM PATIENT INFORMATION AND CONSENT FORM
Dear Patient / Patient Companion,
Our hospital provides specialized services in health tourism, particularly in the fields of orthopedics and traumatology, with a highly qualified team. This form has been prepared to inform you about the services you will receive and your rights, as well as to obtain your consent.
Please read this form carefully and ensure you understand its contents. Feel free to address any questions to our specialists.
1. Scope of Services The services provided by our hospital cover the following areas:
- Orthopedic and traumatology surgeries (prosthetics, arthroscopy, fracture treatments, etc.)
- Spine surgeries
- Hip and knee arthroplasty
- Shoulder and elbow surgeries
- Arthroscopy
- Trauma management
- Pediatric orthopedics
- Hand surgery
- Physical therapy and rehabilitation services
- Post-orthopedic surgery rehabilitation
- Therapy for chronic joint conditions
- Medical consultation and follow-up services
- Comprehensive preoperative evaluation
- Treatment planning and multidisciplinary approach
- Preoperative and postoperative patient care
- Infection control and wound care
- Nutritional counseling
2. Risks and Side Effects You should be aware that the treatment or surgical procedures you will undergo inherently involve risks. Possible risks include:
- Infection
- Bleeding or hematoma
- Complications related to anesthesia
- Vascular blockage (thrombosis)
- Rare cases of nerve or tissue damage
- Prolonged recovery or the need for additional treatments
Each patient’s clinical condition is unique, and the risks specific to your situation will be explained in detail by our doctors. Necessary precautions will be meticulously taken to minimize these risks during your treatment process.
3. Alternative Treatments Please note that there may be alternative approaches to the proposed treatment, and you can learn more about these options from our specialists. Alternative treatment options include:
- Physical therapy and exercise programs
- Medical drug therapy
- Non-surgical injection treatments (PRP, hyaluronic acid)
Our hospital will assist you in evaluating all suitable treatment options.
4. Privacy and Data Security Our hospital is committed to ensuring the confidentiality and security of your health information. Your personal data will only be used for treatment purposes and will not be shared with third parties, except in the following cases:
- Legal obligations
- Payment and claim discussions with insurance companies
5. Costs and Payments Detailed information about the costs of the services will be provided during the preparation of your treatment plan, and you will be informed about the payment methods. Please take note of the following:
- Total cost information before treatment
- Payment plans and installment options
- Notification of possible additional costs
Please review this information carefully and consult our representatives if necessary.
6. Consent I have read and understood all the information stated above. I have evaluated the risks, benefits, alternative treatments, and costs related to the treatment I will receive. I voluntarily consent to the implementation of the proposed treatment and services.
Patient Name and Surname:
Date:
Signature: | Patient Companion Name and Surname (if applicable):
Date:
Signature: | Physician Name and Surname:
Date:
Signature: |
