IOD CENTRE Patient T&C's Acknowledgement
Full Name
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Email Address
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Phone Number
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I
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presented in person for medical services at the IOD Medical Centre.
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I accept the aforesaid appointment request subject to me providing the following information within 24 hours
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Employers report of the accident
Proof of employment
Identity document
The claim number, within 7 days
I acknowledge the below
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If I am unable to provide the aforesaid confirmation within 7 calendar days of the first appointment, I will be held liable for all fees.
NO SHOW POLICY: If an appointment is missed, intentionally or unintentionally, without notice being given at least 24hrs prior to date of appointment it will be deemed a no show. Penalty: In the event of a no show, I will be held liable for the consultation fee.
Signature
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Date
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