Lose Weight

Consent to Disclose Personal Health & Contact Information

I hereby give my consent to share my personal health data and contact information (“Personal Data”) with SunLife Pharmacy for the purposes of providing me with lifestyle modification advice and consent to SunLife Pharmacy collecting, storing and sharing (altogether “Processing”) my Personal Data. I understand that my health information is sensitive and confidential, and I give my permission for it to be processed for the following purposes:

1- To provide me with lifestyle modification advice, referral to HCPs and follow-up care.

2- To communicate with me about my needed lifestyle modifications, including appointment reminders and other health-related information.

3- To coordinate my care with other healthcare providers, as necessary.

I understand that the Personal Data that will be processed may include medical history, test results, medications, and other health-related information. I acknowledge that you have a duty to protect my privacy and will use my Personal Data only for the purposes for which I have given my consent.

I also give my permission for you to contact me using the contact information provided, including phone calls, SMSs & WhatsApp, email, and mailing address. I understand that this information will be used solely for the purpose of providing me with healthcare services.

I understand that I have the right to revoke this consent at any time by sending email or calling the call center, and that doing so may impact my ability to receive certain services from you. I also understand that my Personal Data will be protected in accordance with the applicable laws and regulations governing the confidentiality of health information.