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Public Agreement for the Provision of Medical Services

The Limited Liability Company "Universum Clinic", represented by the Director Bohomolova Nataliia Anatoliivna, acting on the grounds of the Articles of Association, on the one hand  (hereinafter referred to as – “the Institution of health care”), and physical person, who is seeking medical services from the Institution of health care (hereinafter referred to as – “the Patient”), together to be referred to as the Parties and each respectively to be referred to as the Party, have concluded the present Public Contract for the provision of medical services (hereinafter referred to as – “the Contract”) as follows:

1. GENERAL PROVISIONS. THE PROCEDURE FOR CONCLUSION OF THE CONTRACT

1.1. This Contract is a public offer according to the provisions of articles 633 and 641 of the Civil Code of Ukraine and contains all substantial terms and conditions for the rendering of medical services by the Institution of health care, which are indicated in the Price list of medical services. Medical services are rendered by the Institution of health care on the grounds of Medical Practice License No. АД 063792 dated 09.08.2012, issued by the Ministry of Healthcare of Ukraine.

1.2. The terms and conditions of this Contract should be established as identical terms and conditions for all Patients, except the cases, provided by the legislation of Ukraine; the terms and conditions of this Contract are represented in an easily accessible form in the Internet:

https ://uniclinic.com.ua/ua/information/publichnyj-dogovor-o-predostavlenii-medicinskih- uslug/, as well as in paper form at the location of the Institution of health care; the terms and conditions of this Contract should be provided for acquaintance upon the first demand of the Patient.

1.3. The provisions of Article 634 of the Civil Code of Ukraine should be used for execution of this Contract. This Contract is concluded by way of joining the Patient to the Contract on the whole.

1.4. The Patient, seeking medical services from the Institution of health care, is under an obligation to make a written request or a verbal request for provision of medical services and to accept all of the terms and conditions of this Contract without its further signing; and the date of the first encounter of the Patient is considered the date of conclusion of the present Contract on the basis of the mutual consent of the Parties.

1.5. The institution of health care has no authority to cease to be a party to this Contract if it is possible (including technical, personnel, organizational capabilities etc.) to render medical services to the Patient.

1.6. The Patient is under an obligation to accept all of the terms and conditions of this Contract on a full and unqualified basis; the above mentioned acceptance the terms and conditions of this Contract by the Patient is considered that the Patient agrees to the terms and conditions of the Contract without any exceptions and additions, as well as that the Patient understands the value of all actions; all of the terms and conditions of the Contract are clear.

 

1.7. The fact of conclusion of the present Contract may be confirmed by the Patient by way of performing actions, provided by the Contract, indicating that the Patient agrees to the terms and conditions of the Contract  (for example, signing of “Informed Patient’s voluntary consent for medical intervention”, which is drawn up in the prescribed form  according to the legislation of Ukraine; performing payment for medical services etc.).

2. SUBJECT OF THE CONTRACT

2.1. The institution of health care is under an obligation to render medical services to the Patient, which are given in the Price list of medical services on the basis of verbal or writing encounter  of the Patient according to the Order and under the terms and conditions of this Contract, and the Patient is under an obligation to accept the rendered medical services and to perform payment for the above mentioned services. In case if medical services are rendered to underage child or legally incapable person, the legal representative of such person acquires the rights and obligations, which are provided by this Contract for the Patient.

2.2. Medical services are provided according to the industry-specific standard in the field of health care and/or local protocols for rendering of medical assistance, approved according to the established order. Quality of the rendered medical services should be compliant with the requirements of the current legislation of Ukraine.

2.3. Rendering of medical services is carried out according to “Informed Patient’s voluntary consent for medical intervention”, which is drawn up in the prescribed form according to the legislation of Ukraine before provision of medical first aid. Consent of the Patient or his legal representative for medical intervention is not necessary only in case of presence of signs of immediate risk of loss of life of the Patient on condition of impossibility of receiving a consent from Patient or him legal representatives for medical intervention for reasons beyond control.

2.4. The place for rendering of services is considered the address of location of the institution of health care: 4, Vynnychenko Str., Kyiv city. Medical services may be provided at the place of residence (stay) of the Patient subject to applicable legal requirements according to the current legislation of Ukraine and on the basis of requests of the Patient in the event of impossibility to visit the Institution of health care independently in connection with deterioration of health of the Patient.

3. THE PROCEDURE OF PROVISION AND ACCEPTANCE OF MEDICAL SERVICES

3.1. Medical services are provided by medical workers of the Institution of health care, who  has the corresponding special education and meet the unified performance qualification requirements in accordance with the legislation of Ukraine.

3.2. Orders for rendering of services by medical workers of the Institution of health care are made by previous appointment. The patient can choose a day and time of visit to a doctor from the available visiting hours, indicated in a time schedule. Provision of medical services without previous appointment is possible exceptionally in case of absence of previous appointment of other Patients at this time.

3.3. Before beginning of rendering of medical services a doctor, who provides medical services of the Institution of health care to the Patient (hereinafter referred to as – “the Attending Physician”), is under an obligation to inform the patient about a list, composition and cost of all medical services, which will be provided by the Institution of health care by medical prescription of the Attending Physician.

3.4. A date and time of provision of medical services can be changed on initiative of the Patient before ensuing of the term of provision of services.

3.5. A date and time of provision of medical services can be changed on initiative of the Institution of health care in the following circumstances:

3.5.1. Before the beginning of provision of medical service the state of health of the Patient makes it impossible to provide this service or is considered as a risk of origin of complication from the illness, threat to life or health of the Patient or other heavy or negative consequences.

3.5.2. Occurrence of force majeure circumstances, which render impossible the provision of medical services by the Institution of health care.

3.6. The Institution of health care has a right to refuse medical assistance in the following circumstances:

3.6.1. The Patient fails to pay for medical services or the Patient is in arrears on payment for medical services (to the moment of complete discharge of indebtedness);

3.6.2. The Patient is in the state of alcoholic, narcotic or toxic intoxication and/or violates the rules of stay in the Institution of health care;

3.6.3. The Patient did not make an appointment previously for making a visit to a doctor according to the procedure, established in clause 3.2 of the Contract;

3.6.4. The Patient was not present at the doctor or the Patient was late more than by 15 minutes in comparison with the time of an appointment, indicated in Clause 3.2 of the Contract;

3.6.5. The Patient does not follow doctor’s instructions of the Institution of health care or refuses to undergo an examination, which is necessary for carrying out of further treatment or examination;

3.6.6. Provision of services to the Patient is impossible by reason of lack of necessary specialists and/or equipment;

3.6.7. The Institution of health care has a right to refuse medical assistance on rendering of medical services in other cases, provided by the current legislation of Ukraine and/or this Contract.

3.7. The delivery and acceptance of the rendered medical services is carried out in verbal form  or at the request of the Patient by way of drawing up of the Act of delivery and acceptance of rendered medical services (hereinafter referred to as – the Act of delivery and acceptance), which should be drawn up by the Institution of health care in two copies and should be issued to the Patient for its signing. The fact of delivery and acceptance of medical services also can be confirmed by way of issue of the Consultative medical report of the Attending physician with affixing signatures of the Attending physician and the Patient.

3.8. The Patient is under an obligation to sign two copies of the Act of delivery and acceptance  or to raise a written reasonable refusal to sign the Act of delivery and acceptance.

3.9. In case if the Patient did not raise a written reasonable refusal to sign the Act of delivery and acceptance at the time of transfer of the Act of delivery and acceptance, a medical service is considered as rendered service in an appropriate manner by the Institution of health care and it is accepted in an appropriate manner by the Patient.

3.10. At presence of a written reasonable refusal to sign the Act of delivery and acceptance, the Institution of health care should examine such refusal during 14 (fourteen) calendar days and information about the results of examination should be sent to the Patient in a written form.

3.11. In the event of granting a delay/ payment by instalments for rendering of medical services, drawing up of the Act of acceptance and delivery is obligatory. Thus, information about the unpaid cost of medical services as well as the deadline for payment by the Patient should be included in the above mentioned Act.

3.12. If a few medical services were rendered to the Patient by the Institution of health care, the Institution of health care has a right to draw up one Act of delivery and acceptance in two copies, where a list of the rendered medical services will be represented.

4. THE PROCEDURE OF PAYMENT FOR SERVICES

4.1. The total cost of services is determined in accordance with the cost of services, established according to the Price list of medical services, which is valid at the moment of rendering of medical services. The Patient can be familiarized with the current Price list directly in a reception desk or by the phone of the Institution of health care.

4.2. Payment for the rendered medical services is performed by the Patient on the day of rendering of services directly after rendering of services or before rendering of medical services depending on individual cases:

4.2.1. Making payment by the Patient in cash at the cash desk of the Institution of health care;

4.2.2. Making payment by the Patient by means of payment card with the use of payment terminal of the bank of the Institution of health care;

4.2.3. Making payment by the Patient by way of bank transfer (cashless payment) to the settlement account of the Institution of health care, including by means of financial payment  systems.

4.3. The Patient has a right to choose the type of payment. The Institution of health care has a right to refuse the Patient to choose the type of payment exceptionally in case of temporal technical impossibility to make payment by a certain method (including, but not exceptionally – in case of failure of payment terminal of the bank).

4.4. In the event if the Patient has not money in sufficient quantity for making payment for the rendered medical services,  a delay/ payment by instalments for rendering of medical services may be granted to the Patient; Furthermore, the Patient is under an obligation to sign a written  obligation in relation to making of payment. The decision about granting of a delay / payment by instalments for rendering of medical services should be accepted after visiting of the Patient to the Institution of health care. Thus, an acceptance of such decision is a right, but not an obligation of the Institution of health care.

5. RIGHTS AND OBLIGATIONS OF THE PARTIES

5.1. The rights of the Institution of health care:

5.1.1. To make payment for the rendered services.

5.1.2. To perform actions, grant discounts on payment for medical services.

5.1.3. To introduce amendments to this Contract and to the Price list of medical services.

5.1.4. To cancel provision of medical services in case of violation of the terms and conditions of this Contract by the Patient.

5.1.5. The Institution of health care has a right to provide incomplete information about the state of health of the Patient, to restrict possibility of his acquaintance with separate medical documents if as a result of provision of such information about illness of the Patient the state of his health will be worsened or the process of treatment will be endamaged.

5.2. Obligations of the Institution of health care:

5.2.1. To render medical services of the corresponding quality to the Patient in accordance with the procedure and under the terms and conditions, established in this Contract.

5.2.2. To use pharmaceutical products and medical devices, which are certified for the use in  Ukraine.

5.2.3. To maintain and keep medical documentation, accounts and records in accordance with the requirements of the current legislation of Ukraine.

5.2.4. To keep a medical secret in accordance with the provisions of the current legislation of Ukraine.

5.3. The rights of the Patient:

5.3.1. To accept medical services of the corresponding quality.

5.3.2. To receive reliable and complete information about the state of health, including acquaintance with the corresponding medical documents in relation to the state of health, which are kept in the Institution of health care (taking into account Clause 5.1.5 of the Contract).

5.3.3. To receive reliable and complete information about contraindications, possible complications and risks (including for life and health), the projected progress of the disease at the time of provision of medical services.

5.3.4. To require replacement of the Attending physician.

5.3.5. To have a right on keeping a secret about the state of health, the fact of seeking for medical assistance, diagnosis, as well as about information, obtained as a result of medical examination.

5.3.6. To obtain reliable and complete information about the terms and conditions of provision, list, volume and cost of services.

5.4. Obligations of the Patient:

5.4.1. To follow verbal or written instructions and recommendations of doctors of the Institution of health care.

5.4.2. To provide originals or copies of documents which contain information about the state of health, which are necessary to the Institution of health care for provision of medical services.

5.4.3. To pay the cost of medical services in accordance with the procedure and under the terms and conditions indicated in this Contract.

5.4.4. To arrive (to be present) in the place of provision of medical services on the date and time of provision of medical services, established according to Clause 3.2 of the Contract.

5.4.5. Before beginning of provision of medical services it is necessary to send information to the Institution of health care about a list of pharmaceutical products, used by the Patient, as well as about all known illnesses, defects, allergic or specific drug responses, foodstuffs and other substantial information about the state of health.

5.4.6. In case of violation by the Patient or impossibility to follow the Plan of treatment, if such Plan is available, it is necessary to send the above mentioned information to the Institution of health care.

5.4.7. It is necessary to send information to the Institution of health care about improvement or worsening of the state of health, appearance or disappearance of symptoms, as well as other information about changes in the state of health during the period of treatment.

6. PERSONAL DATA OF PATIENTS. CONFIDENTIALITY

6.1. After joining to this Contract the Patient gives a resounding unlimited  consent to the Institution of health care for processing of his personal data (including data about the state of health) according to the procedure and under the terms and conditions, established by the Policy of processing of personal data, which is placed on the website of the Institution of health care: https://uniclinic.com.ua/ua/information/politika-shhodo-obrobki-ta-zahistu-personalnih-danih/", and according to the corresponding current legislation in relation to protection of personal data.

6.2. Processing of personal data of Patients under the present Contract is carried out for the purpose of provision of medical services, determination of a diagnosis and provision of treatment, as well as for the purpose of distribution of information about services and/or promotional actions of the Institution of health care to the Patient, including by way of direct contacts and sending messages of medical, informative and/or advertising type by means of any communication facilities.

6.3. The Institution of health care guarantees that all information about the Patient, which contain medical and/or other confidential information (restricted information), including the personal data of Patients, will be used in accordance with the principles of observance of confidentiality of such information, in accordance with the requirements of current legislation of Ukraine and the terms and conditions of the Contract.

6.4. In the event when the third party (insurance company, a legal entity - an employer of the Patient, a legal entity having the confirmed relations with the Patient) performs payment for medical services, rendered by the Institution of health care, such party acquires the rights of the owner of personal data of the Patients in the context of name, surname, patronymic, the date of  birth, address, contact telephone number, rendered medical services, diagnosis, the results of medical examination.

7. RESPONSIBILITY OF THE PARTIES

7.1. The parties bear responsibility for non-fulfilment of their obligations or for improper fulfilment of their obligations, which is established by this Contract and the current legislation of Ukraine.

7.2. In the event of delay in payment for the rendered medical services the Institution of health care has a right to require from the Patient to pay a fine in the amount of double bank rate of the National Bank of Ukraine which is valid for the period of accrual a penalty from the amount of actual debt for every day of delay in payment.

7.3. The Institution of health care does not bear the responsibility in case of origin of complications for the Patient or for harm, inflicted to life and health of the Patient as a result of the following circumstances:

7.3.1. non-fulfillment of obligations by the Patient, which are provided by this Contract and/or by the current legislation of Ukraine, in particular, non-fulfillment of obligations in relation to execution of instructions and recommendations of doctors of the Institution of health care, treatment plan etc.;

7.3.2. non-disclosure of substantial information by the Patient in relation to the state of health, including complications, which arose up during the period of rendering of medical services, or provision of wrong information;

7.3.3. use of pharmaceutical products (drugs) and medical devices of improper quality by the Patient or use of pharmaceutical products (drugs), which were nor prescribed by doctors of the Institution of health care;

7.3.4. non-disclosure of information by the Patient, which is specified in Clause 5.4.5 of the Contract;

7.3.5. receiving medical treatment in other institutions of health care;

7.3.6. development of diseases or pathologies which are not connected with rendering of medical services under the present Contract.

7.4. The Institution of health care is relieved of responsibility in the event if complications are occurred not through the fault of the Institution of health care (not connected with quality of medical services, rendered to the Patient by the Institution of health care).

7.5. The Parties understand and acknowledge that non-conformity of result of rendering of any  medical service with the result which was expected by the Patient at seeking for medical assistance and provision of the corresponding medical service is not considered as the fact of rendering of service of improper quality.

8. FORCE MAJEURE CIRCUMSTANCES

8.1. The Parties of this Contract do not bear responsibility for non-fulfillment or improper fulfillment of the terms and conditions of this Contract, inflicted harm or caused losses (including for impossibility of execution or delay in execution of obligations), if such obligations are occurred as a result of influence of Force Majeure circumstances.

8.2. Force Majeure circumstances for the Parties are as follows: natural calamities and weather phenomena, in particular, earthquakes, floods, squalls, hurricanes, tornados, thundershower, snow-falls, hail, lightning,  spontaneous fires, as well as revolution, declared or undeclared war, military operations or threat of war, public disturbances, strikes, lock-outs, blockades, embargoes, sabotage, arrests and imprisoning, explosions, industrial accidents or catastrophes, failure of equipment, temporary inability to work of medical personnel of the Institution of health care, epidemics, quarantine restrictions, introduction of amendments to the current legislation of Ukraine, announcement of the state of emergency, requirement and prescriptions of  public authorities, moratoriums and other acts and actions of the bodies of state power,  international institutions and organizations, inaccessibility of transport facilities or cargo carriers, absence of electric energy, interruptions in the supply of water, as well as other phenomena, events and circumstances, which are beyond the control of the Party of this Contract, which is under the influence of force-majeure circumstances, if such Party could not neither foresee their occurrence nor remove influence or consequences of influence of such circumstances by means of present facilities or under the present circumstances.

9. SETTLEMENT OF DISPUTES

9.1. All disputes or disagreements between the Parties should be settled by way of negotiations, in accordance with the current legislation of Ukraine.

9.2. If it is impossible to settle a corresponding dispute by way of negotiations, it should be settled by judicial means according to the established judicial jurisdiction of a dispute and according to the procedure, provided by the current legislation of Ukraine.

10. THE PERIOD OF VALIDITY OF THE CONTRACT, THE PROCEDURE OF TERMINATION OF THE CONTRACT, INTRODUCTION OF AMENDMENTS TO THE CONTRACT

10.1. This Contract shall come into effect from the date of its conclusion; the term of validity of the Contract is unlimited.

10.2. The provisions of the present Contract in relation to payment for rendering of medical services are not applied in cases of provision of medical services to Patients, which are paid by insurers to the Institution of health care in accordance with the voluntary medical insurance contracts (continuous health insurance) or by other third persons in accordance with the terms and conditions of corresponding contracts.

10.3. Amendments to this Contract are introduced by the Institution of health care on a unilateral basis by way of presentation of provisions of the Contract in a new wording and their promulgation:

10.3.1. on the official website of the Institution of health care: https://uniclinic.com.ua;

10.3.2. in paper form at the address of location of the Institution of health care and should be issued for acquaintance upon first request of the Patient.

10.4. Amendments to this Contract can not influence and restrict a quality and volume of medical services in relation to services which were paid by the Patient before entering into effect of such amendments.

10.5. This Сontract can be terminated according to the procedure and according to the method, which are provided by the current legislation of Ukraine.

11. Bank details of the Institution of health care

Limited Liability Company "Universum Clinic"

Legal address: 35/37, V. Stusa Str., 03142, Kyiv city

Actual address (for correspondence): 4, Vynnychenko Str., 04053, Kyiv city

USREOU code 38205119

Settlement account UA 30 322313 0000026000010057998, МFО 322313 at JSC "Ukreksimbank"

TIN 382051126570

License of the Ministry of Public Health No. АД 063792 of 09.08.2012

Telephone (044) 599-54-05, e-mail: med@universum.clinic

Director  Bohomolova Nataliia Anatoliivna

Doctors
appointment