TERMS AND CONDITIONS OF SERVICE:• Ashley Jones (Bright Eyes) Occupational Therapy referred to as the ‘practice’, will not submit claims to medical aids. You are required to pay directly to the practice, via EFT or card payment according to the payment option agreed upon (per session, weekly, monthly). The person responsible for accounts will be held liable for any cost pertaining to interviews, assessment, feedback and/or therapy. Fees are based on medical scheme tariffs and are subject to change according to this. • It is the parent/guardian’s responsibility to submit claims to their respective medical aid for services rendered.
ACCOUNTS:• A monthly account will be issued on the last day of the month. This account is payable upon presentation.• An account statement may be obtained for medical aid submission or personal records on request. Please email requests to accounts@brighteyestherapy.co.za• Therapy will cease PLUS 10% interest will be charged if payment is not received within 30 days of the presentation of the account. • If the account is handed over for collection, all legal fees will be due by the undersigned.• The practice requests that therapy not be prematurely terminated due to financial reasons. Please contact the therapist so that alternative options and payment arrangements can be discussed. • Any change of addresses, medical aid information, etc, should be brought to the attention of the therapist in writing. Please email accounts@brighteyestherapy.co.za
THERAPY AND EVALUATION:• There are risks involved for the child in both the assessment and therapy process. Although your therapist will take the utmost precautions to ensure that your child is safe, the practice will take no responsibility for injuries occurred.• The use of the premises, apparatus and all facilities are done at one's own risk. The practice will not be responsible for any loss or damages or personal injury while at the practice.• The parents/guardians are responsible to render all relevant information regarding the child.• Treatment sessions are usually once a week for 45 minutes. The success of therapy depends on your co-operation and being honest with the therapist. If you feel uncertain, please make a follow-up appointment with the therapist. • If therapy is stopped by the parent/guardian before the end of all the sessions, it may mean that therapy will not be as successful as if continued as recommended.• Formal re-evaluation can only be done after a minimum of six months of therapy (24 therapy sessions). After the re-evaluation, the therapist will advise parents whether or not therapy will be continued or concluded. • If deemed necessary therapy information will be made available to other educational or medical professionals with the parent/guardian’s signed permission of this contract. Reports have different pricing structures. The undersigned hereby consents to the therapist providing a copy of the report to the child’s teacher or school, or will make their objection in this contract.• The therapist has the option to document evaluations or therapy sessions utilizing video /photo documentation, and this is at the discretion of the therapist. All documentary information will be used for feedback to parents/guardian’s listed in this contract. It will be kept confidential and will not be publicised without your consent. The undersigned hereby consents to the recording of sessions for this purpose or will make their objection to the therapist known in the feedback session or in writing in this contract.
CONFIDENTIALITY• Every child that receives therapy in this practice has the right to confidentiality (this means to have your personal information kept private, even from family members and employers). Nothing that you share with the therapist will be shared with anyone, unless -- The law on medical aids forces us to provide certain information to medical aid. When your account is submitted to your medical aid, the account includes personal information, such as what your child’s health status is, and the codes (numbers) that indicate the specific therapy your child received.- When an order from a court to disclose your information is issued, it must be provided.- When a specific law makes it compulsory to report things, such as TB, cancer, child abuse or child neglect.- Communication with the referring doctor, other healthcare professional or an educator, in so far as it is necessary and in the interest of the patient.
PROTECTION OF PERSONAL INFORMATION• I/we, being the parent/s or legal guardian/s of the child, consent to:- Myy/our personal information being collected, processed and stored by the practice in terms of the relevant provisions of the Protection of Personal Information Act 4 of 2013 (POPI) for purposes of the proper functioning, management and governance of the practice,- The patient’s personal information (including academic, attendance, behavioural and other school-related records) being collected, processed, shared and stored by the practice in terms of the relevant provisions of the Protection of Personal Information Act 4 of 2013 (POPI) for purposes of enrolment.• I/we understand that my child cannot be enrolled without the practice processing certain of my/our and his/her personal information as requested by the practice.• I/we confirm that I/we have been informed that the abovementioned personal information will be dealt with in line with the POPI policy, which is available on the software system, alternatively upon request. I also confirm that I am aware that my/our rights with regards to the protection of my personal information is also detailed in this policy.
CANCELLATIONS:• Any cancellation of an appointment should be done 24 hours in advance. Failing to do so will result in a cancellation fee. • Non-arrival for a therapy session will result in payment of a non-arrival fee.
