Patient Consent Form for Collection and Use of Personal and Health Information
As per the Department of Health (DoH) Abu Dhabi standards on Patient Healthcare Data Privacy (September 2020)

We are committed to protecting your personal and health information in accordance with the Abu Dhabi Healthcare Information and Cyber Security Standard and the DoH Patient Data Privacy Standard.

By signing this form, you acknowledge and consent to the following:

Collection of Information:
I authorize Takaful Emarat to collect, process, and store my personal data (e.g., name, contact details, Emirates ID) and health-related data (e.g., medical history, diagnostic records, treatment plans) for the purpose of delivering medical care and healthcare services.

Purpose of Use:
My data will be used solely for healthcare service delivery, insurance processing, regulatory reporting, and service improvement.

Data Sharing and Access:
I understand that my data may be shared with authorized third parties (such as insurance providers, healthcare regulators, or licensed service providers) strictly for the above purposes, and only in compliance with DoH regulations.

Data Security:
My data will be stored securely, and access will be limited to authorized personnel. Remote access from outside the UAE is restricted unless explicitly approved by the Department of Health.

Data Retention:
My data will be retained in accordance with DoH data retention requirements. Personal and health records will be stored securely for a minimum of 10 years (or as specified by law) from the last date of treatment or service, after which it will be securely deleted or anonymized.

Right to Withdraw Consent:
I understand I have the right to request access to my information and may withdraw this consent at any time by notifying Takaful Emarat in writing, except where processing is required by law.