Treatment Agreement

Eye-Q-Vision and the patient will officially agree on the following:
(based on the model doctor-patient form designed by the "Koninklijke Nederlandsche Maatschappij tot bevordering der Geneeskunst en de Nederlandse Patienten Federatie" or in other words, the offical Dutch society for medicine and the Dutch Patient Federation.)

1. U will be informed in an understandable way about a possible consultation and possible suggested treatment procedure.
2. Your permission for a consultation and treatment is required.
3. We might demand your signature if you, against doctor's advice, refuse to have a certain treatment. This also applies to the scenario where your choice of treatment goes against the doctor's advice.
4. If you refuse to supply a signature we will advise you to get treated elsewhere.
5. Permission can be expected to be given automatically if the surgery is a minor procedure with minimal risk.
6. The examinations and treatments for which you have given permission will be executed by the same surgeon whenever possible. If you prefer we can discuss the option of having a different doctor. 
7. The surgeon is your advisor, coach and has the final decision when other people are involved in the examinations.
8. The surgeon offers you responsible care of high quality, specialised to your individual needs.
9. Quality of (after) care is checked periodically.
10. The surgeon is obliged to obey the privacy code. He is to keep any secret private and keep any important information relating to the medical situation of he patient.
11. Patient details are stored in our files.
12. Patient files are stored for 10 years after the first consultation, or longer in ongoing cases.
13. The surgeon is practically always reachable on (+31) (0) 20 640 1104 or in case of emergencies on (+31) (0)6 408 53 181.
14. The patient will, except for emergencies, only contact the doctor during working hours. 
15. The doctor will try to answer any requests made by a patient for an examination. When appropriate he will supply thorough advice. 
16. If the surgeon is absent we ask you to contact one of our colleagues mentioned later.
17. Patient reserves the right to get a second opinion at any time. We advice you to inform your surgeon about this.
18. The surgeon is to stick to the initial financial agreement.
19. Discussions regarding declarations are to go through the federation: "Vereniging voor Extramurale Oogartsen."
20. Patient is responsible and is obliged to ensure on-time payment of the agreed cost, even if the money owed will eventually be paid by insurance or others.
21. The surgeon reserves the right to ask for down payments for any costs occurring before a chosen treatment.
22. Except for emergencies the surgeon reserved the right to require down payments.
23. Both patient and surgeon reserve the right to end the treatment agreement, If the surgeon terminates the agreement he will continue to provide medical information until the patient has found an alternative surgeon.
24. In any case of complaints, the patient is obliged to contact the doctor before anyone else.
25. The surgeon is obliged to provide opportunities for complaints.
26. This contract has a minimum leverage of one year.
27. Eye-Q-Vision has limited responsibility to claims.
28. All treatment requests will only be accepted and executed by Eye-Q-Vision.
29. Juristic discussions about the care, in general or specifically, will oly be accepted through the VVAA in Utrecht, through whom Eye-Q-Vision has its insurance for "Aansprakelijked en Rechtsbijstand" (responsibility and law) .