PERSONAL HEALTH ASSESSMENT

Booking Information

Personal Information



HMO INFORMATION



Booking Information














CONSENT

By submitting this appointment booking form, I consent to the collection, storage, and use of my personal and health information (including sensitive medical information) by MTN for the purpose of:
  • 1. Processing my appointment booking
  • 2. Conducting health screening services
  • 3. Storing and managing my health records

I understand that my information will be handled confidentially and in accordance with applicable data protection laws. I acknowledge that I have the right to:
  • 1. Access my personal and health information
  • 2. Correct or update my information
  • 3. Withdraw my consent at any time

By submitting this form, I confirm that I have provided accurate information and MTN may contact me regarding my appointment or health screening results.
I have read and understood the above consent terms.

  Tick to Consent