By signing below, you are authorized us to review your medical records and use the information obtained to help with your diagnosis and management while the same information will be shared as necessary by team members including nurses, physician assistants, administrative staff, other specialist physicians apart from the primary physician responsible to provide second opinion. Your consent will also allow us to seek medical records from your previous medical providers and institutions. Your medical records will be handled confidentially and results and analysis will be disclosed only to you or your designated person or in emergency situations to your immediate family member. At times, your information may be used to assess our business operations efficacy and quality assessment and improvement. Administrative staff and third party providers may get access to your information in regards to billing and to provide services in relation to your treatment. If anyone would ask for your medical information but their name is not listed by you, they would not be privy to any of your information under any circumstances. This document may be revoked and/or reassigned at your discretion upon submitting your request in writing though we won’t be able to reverse whatever information was utilized or transferred prior to your request. We will follow local law regulations in terms of any circumstances when we need to disclose your information to public health authorities responsible for controlling or preventing diseases, subpoena, court order, law enforcement authorities but will also try our best to inform you on the same. Further more details on this consent can be given to you as per your request.