Email: info@alphahuman.co.za
Address: 150 Rivonia Road, Rivonia Office Park, Sandton, South Africa, 2196

Terms and Conditions

These terms and conditions set the basis upon which the practice and patient, parents, guardians, guarantors, or legal representatives of patients and the practice will conduct their relationship. By signing these terms and conditions, the signatory accepts that they have read the document in its entirety, had the opportunity to ask questions, which have been answered to their satisfaction, and acknowledge that these terms and conditions apply to the medical team at Alphahuman.

I, the undersigned patient, parent, guardian, guarantor, or legal representative hereby agree:

1. Liability for Payment

1. To notify the practice 72 hours in advance if unable to attend a scheduled appointment. Appointments not cancelled will be charged R 3970.00 per hour (consultation fee). Exceptions may be granted at the practice’s discretion.
2. The practice may void warranties on previous work and may refuse treatment to patients who repeatedly fail to attend scheduled appointments.
3. To undertake personal liability for all amounts payable to the practice for services rendered.
4. Should the patient or guarantor fail to settle their account, the practice may record the default with a registered credit bureau.
5. Submitting a claim to the medical aid/scheme or insurer does not relieve the patient or guarantor of liability.
6. I shall be liable for:
   • Any bank charges levied against the practice for declined payments.
   • Legal costs incurred in recovering any amount due, including tracing fees, collection commission, and administrative costs.
7. I acknowledge that fees for services rendered have been fully explained in accordance with the Health Professions Act 1974 and National Health Act 2003.
8. To notify the practice of any changes in address, contact details, or medical aid/scheme information.
9. I acknowledge that fees may differ from medical aid/scheme benefits and accept responsibility for co-payments.
10. The practice may charge interest on unpaid amounts at the maximum legally applicable rate from the due date.

2. Medical Scheme Benefit

1. Terms and tariffs vary from scheme to scheme and plan to plan. It is the patient’s responsibility to obtain these details.
2. The practice may submit accounts to your medical scheme on your behalf unless you instruct otherwise.
3. Pre-authorization does not guarantee payment; obtaining authorization is the patient’s responsibility.
4. Accounts must be settled within 30 days if the medical aid/scheme does not pay.

3. Disclosure of Medical Information

1. The practice may disclose information to medical aids/schemes or insurers regarding the nature, diagnosis, condition, and treatment of the patient.
2. Patients or responsible persons acknowledge that some consequences of disclosure (e.g., ICD-10 codes) may be unknown and must be clarified with the third party.

4. Exclusion of Liability

The practice and its employees shall not be liable for, and the patient indemnifies the practice and its employees from, any loss, injury, or damage of any nature sustained while receiving treatment or services, whether directly or indirectly caused by the practice or its employees.

5. South African Jurisdiction and Law

1. The patient, parent, guardian, guarantor, or legal representative consents to the exclusive jurisdiction of the appropriate Magistrate’s or High Court of South Africa in respect of any disputes arising from these terms and conditions. All disputes shall be governed exclusively by the laws of South Africa.

6. Minor Patients and Warranty of Authority and Indemnity

1. Where the patient is a minor under 18, the guardian(s) shall sign this agreement in personal and representative capacities, accepting responsibility for payment and indemnifying the practice against damages arising from breach of contract.

7. General

1. Patients, parents, guardians, guarantors, or legal representatives:
   • Confirm the domicilium citandi et executandi at the residential address provided in the Patient Information form.
   • Agree that patient records remain the property of the practice but may be released upon written request by the patient or authorized person.
   • Agree that if any provision of this agreement is invalid, illegal, or unenforceable, it shall be severable and the remaining provisions remain in full force.

8. Warranty of Authority and Indemnity

1. The signatory (other than the guardian or guarantor) warrants that they have authority to contract on behalf of the patient and act as their agent, including agreeing to disclaimers and indemnities as set out in this contract.