Patient Consent Form

1. Purpose of This Form

This consent form explains what happens to your medical information when you use Navelia Health's case management services. By signing this form (electronically or by using our services), you are giving us permission to handle your information in specific ways described below.

2. What You Are Consenting To

2.1 Processing of Medical Records

You authorize Navelia Health to:

• Receive and store your medical records and related documents
• Use AI technology to extract, analyze, and structure information from your records
• Translate medical documents between languages
• Create summaries and case briefs for review purposes
• Organize your information in a structured format for healthcare providers

2.2 Sharing with Healthcare Providers

You authorize Navelia Health to share your case materials with:

• Doctors and specialists for pre-review and consultation
• Hospitals and medical facilities for treatment coordination
• Case managers who will coordinate your care
• Interpreters and translators as needed
• Other healthcare professionals involved in your care team

Important: We only share information necessary for your care coordination. You can specify preferences about which providers receive your information.

2.3 Communication

You consent to receive communications from us via:

• Email notifications about your case status
• Messages from your case manager
• Requests for additional information or documents
• Appointment confirmations and reminders
• Service-related announcements

3. Optional Consents

3.1 Use for AI Model Improvement (Optional)

You may choose whether to allow us to use your de-identified case data to improve our AI systems:

• Your name and identifying information will be removed
• Data will be aggregated with other cases
• This helps improve AI accuracy for future patients
• This is completely optional - declining does not affect your service

3.2 Educational Use (Optional)

You may choose whether to allow anonymized case information to be used for:

• Training case managers
• Improving service quality
• Research on healthcare coordination (with ethics approval)

4. Your Rights

Even after consenting, you retain the right to:

• Access: Request a copy of all information we hold about you
• Correction: Ask us to correct inaccurate information
• Withdrawal: Withdraw consent at any time (subject to legal retention requirements)
• Restriction: Request limits on how we use your information
• Deletion: Request deletion of your data where legally permissible
• Portability: Receive your data in a portable electronic format

To exercise these rights, contact us at privacy@naveliahealth.com.

5. Important Disclosures

5.1 Not a Substitute for Medical Care

This consent is for case management services only. It does not create a doctor-patient relationship or authorize medical treatment. Separate consent will be required for any actual medical procedures.

5.2 International Data Transfer

Your information may be transferred to and processed in countries other than your own, including China. We ensure appropriate safeguards are in place to protect your information during international transfers.

5.3 Security Measures

We implement comprehensive security measures including encryption, access controls, and audit logging. However, no system is 100% secure, and you acknowledge this inherent risk.

6. Duration of Consent

This consent remains in effect until:

• You withdraw it in writing
• Your case is closed and retention periods expire
• We cease operations (your data will be handled per our termination policy)

Even after withdrawal, we may retain certain information as required by law (typically 7 years for medical records).

7. Questions and Contact

If you have questions about this consent form or our privacy practices, please contact:

8. Electronic Signature

By checking the consent boxes during registration or case submission, you are providing your electronic signature, which has the same legal validity as a handwritten signature.