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That SCRIPTWISE may access, request, and receive all the relevant and necessary health and personal information from my/my child’s health care provider(s) and their staff, including my/my child’s physician(s), nurse(s), pharmacist(s) as well as other service providers as necessary (hereafter referred to collectively as “health care providers”), to provide me/my child with an authorisation decision from my/my child’s medical scheme. The information accessed, requested and received may include all information concerning (but not necessarily limited to) my/my child’s personal and medical details including (but not necessarily limited to) name(s), date of birth, identity number, medical history, treatment, medical procedures, special investigations as well as any blood and laboratory results.
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I further agree that SCRIPTWISE may interact and liaise directly and repeatedly (by way of e-mail, phone or otherwise), with me/my child’s medical scheme, my/my child’s doctor(s), dialysis and/or infusion unit(s) and any other health care provider(s) and their staff regarding my/my child’s treatment, the use of my/my child’s medication, the authorisation and specific motivation process for this treatment as well as the monitoring, reporting and follow up of any aspects relating to this treatment when necessary.
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I understand that assistance from SCRIPTWISE does not necessarily imply that my/my child’s medical scheme will provide full/partial/any reimbursement for my/my child’s treatment. I understand that I/main member will be responsible for the payment of any levies, co-payments or rejections that may be imposed by my/my child’s medical scheme and agree that SCRIPTWISE may contact me/main member directly in this regard.
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I consent and confirm in my capacity as a parent/legal guardian of my minor child that SCRIPTWISE may process the special or personal information applicable to my minor child.
Consent to information recording and storage:
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I understand that SCRIPTWISE will keep all my/my child’s information confidential and will only use and share this information with a relevant third party, applicable association, treating physician and my/my child’s medical scheme, insofar as is necessary for authorization and delivery of my/my child’s treatment. Furthermore, I understand that my/my child’s dispensing data will be kept/stored for 5 years according to South African Pharmacy Council legislation, where after all my/my child’s information will be destroyed.
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I further understand that authorised SCRIPTWISE employees will have access to my/my child’s personal information which may include all information received and collected from me and/or a third-party/parties, any telephonic recordings of conversations and all written communication.
Right to withdrawal of consent, security and destruction:
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I understand the full extent and meaning of this consent and that I have the right to withdraw this consent at any time.
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I confirm that I have provided accurate personal information to SCRIPTWISE and acknowledge that it is my responsibility to inform SCRIPTWISE of any changes to any and/or all of my/my child’s provided information in order to ensure the accuracy of all my/my child’s details accessed, requested and received by SCRIPTWISE.
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I understand that if there is the reason for me to believe that my/my child’s personal information has not been processed professionally or appropriately and/or has been compromised or misused, that I may contact the Information Officer/Deputy Information Officer of SCRIPTWISE (contact details are contained in the POPIA & PAIA Manual and are also available on the SBuys website - www.sbuys.co.za).
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I may further request access to, correction and/or deletion of, my/my child’s personal information by contacting the Deputy Information Officer (Nadine Grobler). Contact details (e-mail) ngrobler@sbuys.co.za, (fax) 018 786 3705, (physical/postal address) S Buys Pharmacy at Spar Distribution Centre, Corner Kaolin & Radium Streets, Carletonville, 2500.