Terms and Conditions of the Practice

By signing this form, you acknowledge that you have understood and agreed to the following:

I have read, understood and will abide by the Billing Policy of this practice and have had an opportunity to ask questions on aspects thereof that you were not certain about.

If you do not keep your appointment (for any reason whatsoever, apart from emergencies) and you have not let us know at least 24 hours before the appointment, we reserve the right to charge a cancellation fee , as we have kept the slot open for you and could not assist another patient.

The use of a mobile phone is not allowed during the consultation and should be switched to silent for the duration of the consultation. The use of any device to record any part of the  consultation, whether audio or video, is strictly prohibited unless specific prior permission is requested and obtained by Dr LB Linde.

To always ask, even after you have left the practice, if you were uncertain about something. You can ask practice staff or the doctor. If you keep quiet, practice staff and the doctor will assume that you have understood everything and are in agreement with any processes, consents, policies or forms.

I confirm that the information furnished by me above is true and correct and replaces any previous personal information supplied, and I further submit that the above-mentioned address, contact number and email address is my chosen domicilium addresses for the purpose of service of any invoices, statements, notices and/or legal documents.

I confirm that I (the parent/guardian) remain personally responsible for any short payment of my account by my medical scheme and/or the main member of the medical aid on the basis that the medical services was rendered to me personally, or my minor child.

I confirm that I am personally liable for costs of the services delivered by Dr LB Linde to me or my minor child. The fact that I belong to a medical aid does not remove my ultimate responsibility to pay accounts from this practice.

I confirm that I acknowledge that the account for the consultation fee in the practice is to be settled and paid immediately after the consultation. Fees and acccounts due for services rendered as part of a hospital admission are payable within 30 (thirty) days. I confirm that the contact information supplied by me will be used to communicate said account(s) to me.

Should legal costs be incurred by the practice as a result of my non-payment, I acknowledge that these are for my account, at attorney and client rate. Should it become necessary to institute legal proceedings against me for recovery of any amount due, I agree to pay all costs on the scale as between attorney and client, including tracing fees and collection commission + VAT thereon.

I understand that the details supplied by me, on this form are protected in terms of the POPI legislation. Dr LB Linde may however use any of the details provided on this form to pursue payment by me for unpaid accounts.

I also understand that Dr LB Linde may share with and/or refer the details supplied by me as well as my patient records to other medical professionals in the course of the medical treatment required for my treatment, and/or any other party with whom he has a contractual agreement to do so, including your medical aid.

All personal information and clinical information will be retained and disposed of according to the guidelines set out by the Health Professions Council of South Africa.