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I, the undersigned, requesting medical care and treatment at Lilavati Hospital & Research Centre agree to accept the services that help with my diagnosis and consent to any of the procedures to treat any diagnosed medical condition.
I understand that under this General Consent Form. I am accepting the services provided to me which includes any routine procedures or treatments such as physical examinations, blood drawing, administration of medication, diagnostic test (such as X-rays, ECG etc...), use of local anesthesia or other non-invasive procedures. I also acknowledge that an additional consent may be needed for specific diagnostic and surgical procedures.
I understand that these services will be provided by either nurse, physicians, midwives, lab technicians, radiographers, or other healthcare professionals. I authorize the Hospital, to release my medical information, including but not limited to test results, medical report, discharge summary, etc., to myself (as per the Hospital's policies). I also understand that if my medical information needs to be released to a third party, I will need to sign a special consent form for the same.
I authorize Hospital to use my registered mobile number and email address to send SMS for appointments, reminders, secured links for test results and promotional messages as and when required.
I authorize the Hospital, to disclose my medical information for payments related issues to my insurance company or other third parties as may be necessary for billing purposes.
I assume full responsibility for all my items and personal belongings, including money, jewellery, eyeglasses, hearing aids, denture, documents and other valuable personal items. I also understand that I should leave my personal belongings with my accompanied family members for safekeeping and not leave them in the Hospital or with the Hospital's staff for safekeeping. If I need to do so, I will be advised by the nurse in charge on how to keep my valuable in a safe place.
I understand that I will neither make any recording, whether audio or visual, nor make any filming, whether photographic or video, inside the Hospital without clear prior approval. I understand that by signing this General Consent that all of these terms will remain in effect until my treatment is completed.
By submitting your Mobile No / Email ID, you agree to receive Calls / SMS / Emails / WhatsApp from the Lilavati Hospital & Research Centre or its authorised representative, irrespective of your registration on DO NOT DISTURB (DND) with your telecom service provider.

Agree with the above mentioned terms and conditions.

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Patient Details

Thank you. Your details have been added successfully. Please proceed to the OPD counter to make the payment and generate your new LH number.

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