INFORMED CONCENT FORM

INFORMED CONCENT FORM
This form has been prepared to inform the patient about the interventions to be performed on them, the side effects of the interventions in question, the possible complications that may occur after the intervention and the interventions to be performed in case of an emergency. It is the most natural right of the patient to have information about the interventions to be made for his/her personal body integrity The patient must carefully read and examine all the issues stated about the medical interventions that are required to be performed, and if he/she consents for this surgery, she must sign the Informed Consent Form.


YES ___               NO___
Was an interpreter needed to understand this informed consent form prepared about ..................aesthetics??


YES ___              NO___


Did you need a translator to understand this form?

 YES ___              NO___


Patient’s;                                            

 Patient’s;
Legal Representative if there is any (Custodian / guardian);

Turkish Republic

Identity Number:

 

Name and Surname: 

Date of Birth:

Phone Number:

Address:



This form has been prepared to give information about the operation of ……..………. Operation of ................... can be done under general anesthesia and local anesthesia. Local anesthesia is to make the area where the application is performed insensitive to pain for a certain period of time. (In patients who are undergoing local anesthesia, medical intervention is performed in a way that they can react to what is happening around them without loss of consciousness.) In patients who are going under general anesthesia, consciousness is completely closed for a certain period of time and there is no response to stimuli in the outside world. Before general anesthesia, some tests will be applied to you by the anesthesiologist. As a result of these examinations, it will be determined whether you are suitable for general anesthesia. The choice of general or local anesthesia will depend on your decision together with your doctor.
Apart from being health-oriented, aesthetic surgery operations are generally focused on patient satisfaction. For this reason, before the surgical operation is performed, clearly share the parts you do not like physically and want to be corrected with your physician and pay attention to the opinion of your physician who is an expert on this subject. If you request interventions that may impair your health, pay attention to the advice of your physicians to choose the most appropriate treatment for you.
Your doctor will decide on the types of incisions called “Open” or “Closed” in the operation field. In open surgeries, rarely a scar that is visible to the naked eye may remain. This scarring event is not a doctor's fault. It is related to your skin type. Although the operation time varies according to the physical characteristics of the customer, it may take …… hours.
As a result, in these type of surgeries, the patient's face shape and the availability of bone structure are evaluated together, a better appearance and function is tried to be provided by the patient and the physician as a result of a common consensus. A perfect result can never be guaranteed. After analyzing the physical characteristics of the patient, the best possible result is tried to be obtained.
Complications That May Occur During Surgery in Informed Consent Form
Excessive Bleeding in the Operation Area: Although low blood pressure anesthesia and drugs that reduce bleeding are used, it may rarely bleed more than normal in surgeries. These bleedings are usually controlled with the help of an anesthesiologist (by lowering blood pressure).
Local Anesthesia Risks: Allergic reactions can be seen depending on the substances applied and this can be life-threatening. However, the possibility of development is very low.
General Anesthesia Risks: As indicated in local anesthesia, besides allergic reactions, sore throat, hoarseness, nausea, vomiting, high / low blood pressure, neck pain, back pain; and in rare cases lip, tongue, tooth and throat damage, allergy and nerve damage can be seen. Clots can form in blood vessels, along with pain and swelling. Very rarely, this clot can detach from its location and travel to the lungs which can be fatal. Heart attack or stroke may develop due to heart strain. These risks are standard risks that can be predicted for every surgery.
Postoperative Complications in Informed Consent Form
First of all, anxiety (tension) and mental trauma may occur in the patient after the operation. This is normal and will go away within a few hours.
DIFFERENT POINTS OF ATTENTION ABOUT OPERATIONS TO BE DONE.
Infection: Every surgical intervention means the opening of the skin, which is the most important defense organ of the body, and in this case, there is a risk of infection of the opened area. Any wound that is infected has the possibility of causing ossitis, abscess, widespread inflammation, severe microbial disease of the body, brain abscess, meningitis, and even death. This risk is extremely low in the surgery performed by a specialist physician in a suitable environment. The appropriate hygienic environment should be provided by the patient himself/herself after the surgery.
Points to be Considered After Surgery in the Informed Consent Form
DIFFERENT POINTS OF ATTENTION ABOUT OPERATIONS TO BE DONE.
Follow the post-operative recommendations during discharge, consult your doctor in unexpected situations such as signs of infection, bleeding or suspicion of bleeding.
Take your medication at the time and time recommended by your doctor.
Do not skip your control appointments.
I READ AND UNDERSTAND THIS LIGHTED CONSENT FORM PREPARED ONLY FOR ……………………… .. I KNOW THE PHYSICIAN WHO WILL DO THE SURGICAL INTERVENTION AND I DON'T WANT ANY OTHER DOCTOR TO HAVE THE SURGICAL INTERVENTION, BECAUSE OF THE WORK CONTRACT BETWEEN US. I CONSENT TO MEDICAL INTERVENTION TO BE MADE TO ME. UNDER THESE CONDITION I AGREE TO HAVE ................. SURGERY.
Date:
Name and Surname of the Patient
Signature: 
Custodian / guardian of the Patient
Name and Surname
Signature:

RELATED PRODUCTS

WEBSITE USER AGREEMENT

1.1.   This user agreement and other rules on the Website regulate the terms and conditions regarding the services offered by Turkeyanaand the rules regarding the use of the Website. The User is deemed to have undertaken to comply with this Agreement from the moment he/she approves this Agreement or starts to benefit from the Website while creating a Service Request on the Website. If the conditions are not suitable for you, please do not use the Website and the services provided..
1.2. Turkeyanahas the right to unilaterally change or amend the Agreement to ensure the continuity of intermediary services, to comply with future technical necessities or legislation, provided that it is not against the Users ofTurkeyana , in case of any changes, will publish the updated terms of use on the Website with the new date update under the same link, if it deems necessary, update will be notified to its users by e-mail or mobile push notification and submit it for approval. The renewed current Contract will be valid from the moment it is published on the Web Site and the use of the Web Site or its services will be subject to the terms of the renewed Contract from that moment on.

Definitions
In the text of this Agreement;
2.1. " Turkeyana " refers to TURKEYANA CLINIC SAĞLIK TURİZMİ LIMITED COMPANY,
2.2. " Website " refers to the https://shop.turkeyanaclinic.com website and IOS / Android based Mobile Applications,
2.3. " User " refers to people who use the Website for any reason,
2.4.  " Member " refers to the User who sets a username and password for him, subject to the acceptance of this User Agreement by registering e-mail,
2.5. " Service Receiver " refers to the natural or legal person User who sends a Service Request to purchase any service offered by the Service Provider through the Website,
2.6. " Service Provider " (Service Provider within the scope of the Regulation) refers to the person, organization or legal person who ratifies this User agreement through the Website to provide services (If the Service Provider is a legal person, the aforementioned definition refers to the persons who perform the services on behalf of the Service Provider and also covers the people work under the Service Provider), 
2.7. " Fixed Price " refers to the standard unit price that was announced in advance for the service through the Website and will be paid to the Service Provider by the Service User in the Reservation System upon the orientation of the Service Provider,
2.8. " Agreed Work " refers to the acceptance of the Proposal sent by the Service Providers through the System by the Service User or the approval of the Service Request via the Reservation System for some services according to the nature,
2.9. " Online Payment System " refers to the system that allows the Service User to collect the fee for the service to be received through the Website by credit card, debit card, or other payment methods provided by banks under the terms and conditions specified in this Agreement,
2.10. " Agreement " refers to this User Agreement,
2.11. " Regulation " refers to the Regulation on Service Providers and Intermediary Service Providers in Electronic Commerce published in the Official Gazette No. 29457 dated 26 August 2015,

Services Offered by Turkeyana Clinic Health Tourism Ltd. Sti.
3.Turkeyana Clinic Health Tourism Ltd. Sti. provides the service of hair transplantation, simple aesthetic operations and accommodation services on the Website within the scope of this contract.

TERMS OF USE
Article 4. Membership System
4.1. Membership to the Website is free. Members can submit multiple Service Requests simultaneously through a single Member account. Determining and protecting the password is the user's own responsibility. Username and password should not be shared and should be carefully protected. He/she is directly responsible for the misuse of the member account by other persons due to his/her own fault. The SERVICE PROVIDER has the same right of recourse to the Member for any judicial / administrative fines and / or compensation that it will have to pay for this reason.
4.2. When creating a member account, all kinds of information such as name, address, telephone, e-mail, tax office declared on the Website must be up-to-date, accurate and complete. SERVICE PROVIDER is not obliged to check the accuracy and currency of the information in question. Responsibility for damages incurred by Members or third parties due to incorrect or incomplete information in question belongs to the relevant Member. 
4.3. Usage rights, user name and password for membership cannot be transferred to others.
Article 5. Payment
5.1. Service Users can instantly pay the fee for the service through the Online Payment System, debit card, credit card or a similar payment tool and other payment systems after the agreement is approved. In payments made with the Online Payment System, if the card is used illegally by someone other than the holder, transactions are carried out according to the Law No. 5464 dated as 23.02.2006 and according to provisions of the Regulation on Bank Cards and Credit Cards published in the Official Gazette dated 10.03.2007 and numbered as 26458.
5.2. When using the Online Payment System, receipt / invoice or other documents required to be issued are issued by the relevant Service Provider if there are regulatory obligations as per the relevant legislation.. 

Article 6.Return of Service Fee / Exercise of Right of Withdrawal
6.1. The Service Receiver has the right to withdraw from the contract within 14 days following the agreement with the Service Provider without stating any justification and paying penal terms, provided that the service has not been performed and the service has not been initiated.
6.2. If the service receiver does not fulfill its responsibilities and commitments by acting against any article of this contract, or if the information that he/she stated in the cover page of this agreement is found to be inaccurate, then the SERVICE PROVIDER has the right to terminate the contract unilaterally without any warning or notice..
6.3. The customer has the right to terminate this contract at the end of the term provided that the customer notifies the contract in written 10 days before the service will be provided, without any justification.
6.4. In case the service is terminated or canceled by the customer before the termination period, it declares, accepts and undertakes to pay the service fee for the period from the date of termination to the end of the contract / service in advance..

Service Liability, No Warranty and Relationship Independence
Copyright Policy

8.1. Visual and written content presented on the Website is for personal use. https://shop.turkeyanaclinic.com is the owner of all domain name, logo, graphic, sound, icon, design, text, image, html code, other codes, demonstrative, written, electronic, graphic or machine-readable technical data, applied sales system, business method and all materials (" Materials "), including the business model, and the intellectual and industrial property rights, or is license holder and it is protected by law. Unless otherwise stated, it cannot be used for commercial or personal purposes without permission or reference.
8.2. The software used in the design of these pages and database creation belongs to shop.turkeyanaclinic.com. It is strictly forbidden to copy or use the aforementioned software, and it is prohibited for the software and technologies that are used to be subjected to reverse engineering. 
8.3. The copyright of all comments and criticisms transmitted to https://shop.turkeyanaclinic.com belongs to https://shop.turkeyanaclinic.com reserves the right to make various changes on the comments in question, to delete or remove them completely, and may not publish some of the comments. https://shop.turkeyanaclinic.com reserves the right to use all information, comments and criticisms linked to the user account in relation to its marketing activities, provided that the terms of use, privacy principles and valid legal regulations are adhered to.
8.4. The user accepts in advance that the content of the profile created on https://shop.turkeyanaclinic.com will be indexed by various search engines, that search sites can be viewed on search result screens and can be seen by third parties / institutions, and that he/she will be held responsible for if the information shared on the profile contains any illegal actions .
Contact and Information Addresses
9.1. The parties have accepted, declared and committed the postal addresses specified in the order address as their legal residence for any notification arising from the contract.
9.2. Any notices made to these addresses will be deemed to have been served even if they do not reach the parties. Unless the changes of these addresses are notified to the other party in writing, the old addresses will be valid.
9.3. SERVICE PROVIDER may send a message, information, letter, warning, payment notification, account movement chart, statement of account to the e-mail address allocated to the customer within the contract period. The customer cannot claim that the said electronic messages are not received or not delivered to him/her, and he/she also declares, accepts and undertakes that the said messages will be deemed to be legally served 1 day after the date they are sent.
Default in Payment of Wages
10.1. If the customer does not pay for the services received within 7 days following the application date, it is considered to be in default. In this case, the SERVICE PROVIDER may issue an exchange rate difference invoice or request a monthly delay interest of 15% from the invoice date. The customer declares and accepts to pay this delay interest and exchange difference invoice.

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