Consents

1. Data protection controller

The entity responsible for processing personal data, and in particular health data, is 360 AG Kinderwunschzentrum Zurich (hereinafter referred to as the Controller). If patients have any questions about data protection or wish to exercise their data protection rights, they can contact their treating physicians or the practice staff.

2. Data protection information and consent

With my signature, I confirm that in the course of the processing of personal data, only those data will be collected that are suitable and necessary for the fulfillment of the task or the achievement of the stated purpose. I have also been informed that the personal and health data collected will be kept only for as long as is necessary to fulfill the task or for as long as is not required by law. I am aware that I have the right at any time to request that my personal data be provided to me or that it be passed on to third parties.

I also confirm that I have been informed about the concept of particularly sensitive personal data and that my consent is an express consent to the collection of particularly sensitive personal data. This consent is given on a voluntary basis and after having received adequate information on the nature and purpose of the data collection. I consent to the processing of my data, the access to this data by the physician or therapist and the disclosure of this data to third parties in accordance with the table below and the patient information in the appendix.

am aware of the possible risks involved in the exchange of particularly sensitive personal data (possible access by unauthorized third parties via insecure communication channels, such as video call (e.g. Microsoft Teams or similar) or via email, e.g. hin-secured @360grad.ch address to recipient address such as @bluewin.ch, @gmail.com, etc.) as well as my rights and give my consent for mutual contact between my doctor or therapist and myself as a patient via the contact information provided above, in particular via the e-mail address I have provided. This also applies to the exchange of data within the practice and for substitutions. I also agree to the use of QR codes and for prescriptions or medical certificates with a digital or electronic signature.
My personal data may be transferred to and stored by the debt collection agency Mediserve AG (inkas) for the purpose of credit assessment.

In principle, my data will initially be stored by the practice for core applications exclusively in Switzerland. For the purpose to obtain the medical history online, of targeted patient education, training and counseling, and as part of the consent process prior to interventions, limited data may be transferred to specific portals in other European and non-European countries using multimedia and eSign services.

Type of data and data processing:

3. Data transmission for accounting and debt collection in the event of late payment

If necessary, the Controller may use specialized companies for accounting (invoicing, debtor control, debt collection, bookkeeping) and transfer the necessary data. If I do not meet my payment obligation within the payment period or if I waive a justified objection, I will be in default after this period has expired without any further reminder. The Controller may at any time engage third parties for collection. I agree to be responsible for any costs incurred in collecting. In case of collection problems, the Controller will cooperate with a collection agency (e.g. FMH Inkassostelle Inkas AG, 2501 Biel, or others), which will contact the collection agency. In the event of debt collection, the patient releases the attending physician from professional confidentiality with regard to the patient's name and address, the outstanding invoice amount and the date of the invoice.

4. Invoice processing

The Swiss Federal Law on Health Insurance (KVG) requires that patients receive a copy of the doctor's bill. By signing this form, I accept to receive the invoice on paper or electronically in Tiers Payant (invoice sent directly to the insurance company). For the sake of simplicity, the notification of the copy of the invoice (only in Tiers Payant) will be sent to the E-mail address I have provided, and the name of my doctor, therapist or practice will be indicated in the E-mail to make it easier for me to read.

5. Data transmission to the partner

The Center assumes that (married) partners will inform each other of any findings. Accordingly, we allow employees to provide information about one partner to another.

6. Notification of address changes, new telephone numbers and E-mail addresses

It is essential that changes of address, telephone number or E-mail address during an ongoing treatment are always communicated to us without being asked, so that we can always communicate changes to a therapy.

7. Fertility treatment and medical care

Our focus is on fertility treatment. Care at our center does not replace regular medical check-ups by your specialist.

8. Risk of multiple births

Hormone therapy often results in multiple pregnancies. These are considered high-risk pregnancies and have limited prenatal diagnosis options. We will provide you with appropriate information in each individual case.

9. Manufacturing process for medicines

Some commercially available drugs are obtained from human sources (urine) in a highly purified pharmacological process. Theoretically, there is a residual risk of contamination and transmission of infectious agents (e.g. prions), but this has never been observed in practice.

10. Dispensing of medication

You have the option of obtaining the medication directly from us at the center or from a pharmacy of your choice.

11. Medicines no return policy

Unfortunately, as is standard pharmacy practice, we are unable to accept returns or refunds for medications that have been dispensed.

12. RI IVF Witness

For your safety, our center was the first in Switzerland to introduce the RI IVF Witness monitoring system. For certain therapies (e.g. insemination, IVF, etc.), this system systematically monitors and records all incoming and outgoing patient samples as well as all key treatment steps in the center and actively and passively prevents mix-ups in the laboratory. There is a charge for this service, which is usually not reimbursed by health insurance companies and is provided on a separate self-pay invoice in addition to the health insurance benefit.

13. Infection screening

We agree that as part of the infertility evaluation, both partners will be tested for HIV and other relevant infectious diseases such as chlamydia, hepatitis and syphilis.

14. Thrombosis risk with drug therapy for fertility/contraception

Hormone preparations can trigger thrombosis or embolism (= blockage of arteries with rare life-threatening oxygen deficiency in organs, e.g. pulmonary embolism) as a side effect.

15. Cost of treatment

There are certain types of tests and treatments that are not covered by health insurance and have to be paid for by the patient. This is often the case with genetic testing, in vitro fertilization (IVF) and fertility treatments after the age of 40, as well as certain medications in general (e.g., ovulation inhibitors or urine tests).

16. Choice of Law & Place of jurisdiction

1. Choice of law: The legal relationship between the parties and in particular all claims in connection with examinations, treatments and any other services (with Dr. Götze or colleagues) shall be governed by Swiss substantive law, namely the Swiss Code of Obligations.
2. Place of jurisdiction: All disputes arising out of or relating to this Agreement shall exclusively come under the jurisdiction of the courts of Meilen, Switzerland. Dr. Götze and colleagues are also entitled, at their own discretion, to take recourse to the ordinary courts at the patient's place of residence.

On the basis of the above and any further verbal declarations, I hereby give my consent to the processing and transfer of my personal data as described above. I further acknowledge that I may revoke my consent, in whole or in part, at any time without prejudice to the lawfulness of the processing carried out on the basis of the consent until the revocation. The revocation must be made in writing. In addition, my request for deletion will not result in the deletion of my data, as the responsible health professional or practice is legally obliged to retain my data. Therefore, the request for deletion will only result in the deletion of my data by my treating physician or practice in justified exceptional cases, if the deletion is confirmed. At the same time, I hereby release my treating physician from the legal obligation to retain the data in this case.

17. Multimedia education, provision of patient information, digital signature and prognosis calculation

Personal data is collected via an online questionnaire (Meditex Online Survey). In this questionnaire, your personal master data and your health data are transmitted to and processed by Critex GmbH (Meditex) (hereinafter referred to as the "Portal").
For the digital signature on electronic forms (eSign) and for the provision of individualized medical education and information material, your data will be automatically transferred to EngagedMD (hereinafter "Portal").
In order to calculate an externally validated treatment prognosis based on machine learning, a limited selection of data is transmitted to Univfy (hereinafter "Portal"), which can be used to generate an individual report for the patient.
Data may be exchanged with Levy Health and Meditex (hereinafter "Portal") in connection with the collection of information and diagnosis.
The portals process and store this data as follows:

• Patient profiles are created on the basis of the demographic data provided by the patient's medical service provider (360 AG).
• Data and signed electronic documents are stored and shared with authorized medical personnel as needed to support the patient's care.
• Digital records, including system activity and electronic signatures, are retained to further support the patient and healthcare provider.
• Anonymous system analytics are performed periodically to gain insights and improve the user experience on the platform.
• At any time, the patient or provider can request that their data be removed from the portal.

Depending on the portal, the data is stored and processed in the United States or the EU. Both are in compliance with the new Data Protection Act in Switzerland (nDSG) and the EU General Data Protection Regulation (DSGVO). Third parties are used by the portals for the necessary storage and processing after consultation with 360 AG. Your personal data will not be disclosed outside of this purpose. Portals may use your data in anonymous or aggregated form without the possibility of identification to improve their services or for other business purposes.

Patient information on the handling of personal data

Data processing requiring consent

Your consent applies to the practice and its doctors, therapists and medical staff (as responsible persons), as well as to the aforementioned recipients. It is also considered as an express release from professional secrecy in accordance with Art. 321 StGB, insofar as this is necessary for the purpose of the activity. Your consent applies to the entire handling of personal data, regardless of the means and procedures used, and in particular to the collection, storage, preservation, use, modification, disclosure, archiving, erasure or destruction of data.

Responsibilities

Praxis 360 AG is responsible for the processing of your personal data and in particular your health data. If you have any questions about data protection or if you wish to exercise your data protection rights, please contact the practice staff or your doctor or therapist directly.

Collection and purpose of data processing

Your information will be processed (collected, stored, used and retained) on the basis of the Treatment Agreement and legal requirements to fulfill the purpose of the treatment and related responsibilities. On the one hand, data is collected by the attending physician as part of your treatment. On the other hand, if you have given your consent, we may also receive information from other physicians and health care providers who have treated or are treating you. Only information related to your medical treatment is processed in your medical history. The medical history includes the personal information provided on the patient form, such as personal information, contact information, and insurance information, as well as, among other things, the consultations performed as part of your treatment, health information collected such as medical history, diagnoses, treatment recommendations, and findings.

Data transfers requiring consent

As a matter of principle, data processing is based on the legal grounds of documentation of the patient's medical history, data retention obligations and billing, including debt collection. We will only disclose your personal information, and in particular your medical information, to external third parties if this is permitted or required by law, or if you have consented to the disclosure as part of your treatment. The information will be disclosed to your health, accident or disability insurer for the purpose of billing for benefits provided to you. The type of information transferred is based on legal requirements.

• Data will be forwarded to cantonal and national authorities (e.g. cantonal medical services, health departments, etc.) on the basis of legal reporting obligations.
• For debt collection purposes, the necessary patient and billing information is provided to the collection agency.

Duration of storage

Your medical history will generally be kept for 20 years after your last treatment. It will then be destroyed unless otherwise agreed. In some cases, depending on your treatment and your consent, information may be disclosed to other authorized recipients (e.g., laboratories, other physicians, therapists).

Withdrawing of your consent

Doctors and therapists are required by law to maintain your information and medical history. Withdrawing your consent to data processing is contrary to this legal obligation. This also applies to the data processors listed above under Recipients. This means that the processing of personal data in the context of medical treatment and therapy is also regulated by law (MedBG, KVG and cantonal health laws), whereby the persons responsible at the recipients are also legally bound to secrecy as auxiliary persons (Art. 62 DSG and Art. 321 StGB). Art. 31 lit. e DSG applies without restriction to the disclosure of anonymous data. Should you nevertheless wish to revoke your consent in whole or in part, you must do so in writing. If the data processing cannot be based on a legal basis other than consent, the processing will be discontinued. The lawfulness of the data processing carried out up to the time of revocation shall remain unaffected by the revocation.

Information, inspection and disclosure

You have the right to obtain information about your personal data and can request a copy of your medical history. You may be required have to pay a fee for this copy. You will be informed in advance of any costs, which depend on the time and effort involved in producing the copy.

Right to data transfer

You are entitled to have the data we process automatically or digitally disclosed to you or to a third party in a commonly used machine-readable format. This applies in particular to the communication of medical data to a health professional of your choice. If you request a direct transfer of data to another controller, we will only do so if it is technically feasible.

Correction of your details

If you discover or believe that your data is incorrect or incomplete, you have the option of requesting rectification. If neither the correctness nor the incompleteness of your data can be determined, you have the option of attaching a note of dispute.