Tele-healthcare Service Consent Form

Please read the following precautions when receiving online healthcare service.

1. This appointment is for a tele-healthcare service, “tele-healthcare consultation (provided by medical doctor)” defined by Japanese ministry of health, labour and welfare. This service involves an interaction between medical doctors and a patient through the use of information and communication devices, and providing necessary medical advice based on the patient’s individual physical and mental condition. Please note that, this service is not a telemedicine service, thus specific medical decisions such as diagnosis and prescription are not included.

2. Online healthcare will be provided only when the patient fully understands the benefits and disadvantages of online healthcare and when the doctor and patient agree on the use of tele-healthcare service. Please refer to "Benefits and Disadvantages" of tele-healthcare service.

3. You need to understand that the information available to the physician is limited in online healthcare.

4. You will use your own computer, smartphone, or tablet device.

5. It is your responsibility to implement security measures to prevent information leakage from your terminal, and to keep the applications and operating system (OS) used for online medical care up to date. Please update your applications and operating system (OS) as necessary to keep them up-to-date. Please update your applications and operating system (OS) for online healthcare as necessary to keep them up-to-date.

6. Our team will record online tele-healthcare services for the purpose of preparing your healthcare summary.

Please refer to our Privacy Policy on our website for information on how we handle personal information.

7. During tele-healthcare service, taking photos (including videos) or recording audio without permission is strictly prohibited.

8. Sharing any information obtained from the tele-healthcare service to a third party who is not present during the tele-healthcare service is strictly prohibited.

9. You are responsible for all events that may occur as a result of receiving tele-healthcare service.

Please understand that our company will not be held responsible for any liability unless it is intentional or negligent.

10. The registered data may be processed anonymously and used for research such as conference presentations and journal publications, clinical research, and commercial secondary use.

Please refer to the Privacy Policy on our website for information on how we handle personal information.