Consent and Declaration

    I, the undersigned, declare that the above information provided by me are true to the best of my knowledge and hereby provide my consent to the Medical Staff at Manipal Hospital to provide Medical Care, Treatment, Conduct Investigations and Diagnostic Procedures necessary for the above mentioned individual. I also understand that Manipal Hospital will not be responsible for any loss, damage or theft of any Personal Property/Belongings of Mine/Patient/Visitors within the Hospital Premises, including Patients rooms and Parking area. I agree to follow all the rules and regulations of the Hospital and clear all the expenses incurred for My/Patient treatment on time as per the Terms and Conditions of Manipal Hospital.

I would like to receive Self/Patient reports by Email
I would like to receive Hospital Info Alerts reports by Email

If consent provided on behalf of the patient.

I hereby give my consent and authorize Manipal Hospitals to process, store,use,disclose my personal or sensitive information/data collected as per Manipal Privacy Policy