I have availed of the vaccination program against Covid-19 in Chong Hua Hospital. Accordingly, personal and health information, such as but not limited to personal details, health information and travel history, shall be provided to Chong Hua Hospital for this purpose.
By clicking the tick box below, I absolutely agree to the following;
I believed that Chong Hua Hospital shall ensure that the data collected shall be reasonably and appropriately secured and shall only be disclosed or shared to those allowed by law to received it.
I understand that the disclosure or sharing of my personal and health information to DOH and appropriate government agencies is a legal mandate hence my consent or approval thereof is immaterial, provided however, that existing disclosure and sharing protocols are strictly observed. Notwithstanding, I hereby authorize Chong Hua Hospital to release my personal and medical information to DOH or any appropriate government agency when demanded to do so.
Finally, I hereby release, exempt, discharge and free Chong Hua Hospital, its officers and employees, from any liability or responsibility by reason of the disclosure or sharing of my personal and medical information as stated herein.