Name
  • CONSENT TO HANDLE COMPLAINTS & COMPLIMENTS By signing this form, I hereby give consent to Shomang Group to:
    • Receive, manage, and respond to patient complaints and compliments on my behalf.
    • Receive, manage, and respond to patient complaints and compliments on my behalf.
    • Maintain confidentiality and comply with applicable data protection and healthcare regulations, including POPIA and GDPR.
    • Process personal data lawfully and fairly, ensuring rights to access, correction, and withdrawal of consent.
PAYMENT AGREEMENT:
  • I agree to subscribe to the services provided by Shomang Group at the following rate:
    • Annual: R600 per year (non-refundable) The amount is payable in order to resume the service.
    • Subscription fees are payable in advance.
    • Annual fees are not refundable if I choose to cancel before the end of the 12-month period.
    • Failure to make payment may result in suspension of services.
    • Payment-related data will be processed in compliance with POPIA and GDPR.
  • TERMS AND CONDITIONS:
      By signing this form, I confirm that:
      • I have read and understood the terms outlined above.
      • All the information provided is accurate.
      • I agree to comply with any applicable service terms or policies provided by Shomang Group.
      • I will adhere to the set turnaround times as set out in the Service Level Agreement below.
      • Acknowledgement includes data protection compliance under POPIA/GDPR
SERVICE LEVEL AGREEMENT:
  • Shomang Group commits to the following service standards:
    • Acknowledge complaints within 24 hours.
    • Initial response to patient within 48 hours.
    • Resolution timeline within 5–7 working days (depending on complexity).
    • Escalation if unresolved within 7 days.
    • Feedback to doctor via summary report monthly or upon request.
    • Compliment handling shared within 48 hours of receipt.
  • Doctors are expected to:
    • Respond to internal queries within 48 hours.
    • Provide necessary documentation or feedback to assist in resolution.
    • Notify Shomang Group of any changes in contact details or practice status.
  • Signed on behalf of the client
Full Name
  • Signed on behalf of Shomang Group
Full Names