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
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