Treatment Terms & Conditions

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1. Purpose of Consent
I (“the Patient)consent to receive medical and nursing care from Wound Well, which may include but is not limited to:

• Wound assessments

• Wound cleaning and dressing

• Compression therapy

• Negative pressure wound therapy (VAC)

• Debridement procedures (sharp, enzymatic, or autolytic)

• Health education and aftercare instructions

• Referral to other specialists where clinically indicated 

 

2. Nature of Treatment
I acknowledge that:

The healthcare provider will explain the nature, purpose, benefits, risks, and potential complications of the proposed treatment. Treatment may involve the use of various dressings, topical agents, pressure management techniques, and procedural interventions based on clinical judgment. My treatment plan may change over time based on wound progression or deterioration. No guarantees or promises have been made to me regarding the outcome of treatment.

3. Payment Terms and Financial Responsibility
I acknowledge and agree to the following payment structure for services provided by Wound Well:

 

3.1. Consultation Fees

• First Consultation: The first consultation is always charged at the full consultation rate and is due on the day of the appointment at a rate of R645.00.

 

Follow-up Consultations: Subsequent visits are charged at the follow-up consultation rate of:

• R125 for appointment follow ups needing less than 15 minutes

• R280 for an appointment lasting 15-30 minutes,

• R460 for an appointment requiring 30+ minutes

• Consultation Fee per Visit: A consultation fee is charged at each visit, including all follow-up appointments and home visits. If additional services are required during a visit (e.g., dressing changes, wound care procedures), these will be billed separately.

 

3.2. Medical Aid Patients

Medical Aid Claims: Wound Well will submit claims to your medical aid provider on your behalf, where applicable.

• Short Payments/Co-payments: I understand that I will be liable for any short payments, co-payments, or outstanding balances not covered by my medical aid.

• Medical Aid Rates: Wound Well strives to charge according to medical aid rates for all services rendered, ensuring that charges remain aligned with industry standards.

 

3.3. Consumables

• Consumables Charged Per Item: Any consumables used during my appointment, including but not limited to dressings, bandages, gauze, ointments, and other medical supplies, will be billed separately. I understand that I will be charged for each item used during my visit.

 

3.4. Extra Procedures

• Extra Charges for Complicated Procedures: In cases where additional or more complex procedures are required, such as debridement (sharp, enzymatic, or autolytic), I understand that these will be billed separately, in addition to the standard consultation and consumables costs.

 

3.5. Home Visit and Travel Fees

 

• Home Visit Fee: If I request a home visit from a Wound Well practitioner, I understand that a travel fee will apply to cover the cost of travel to my location. Base Travel Fee: A R200 travel fee applies for home visits within a 10 km radius from the Wound Well clinic. Additional Distance: For home visits beyond the 10 km radius, a fee of R8 per kilometer will be charged for each additional kilometer traveled, calculated based on the round-trip distance (to and from the patient’s home).

 

• Travel Time Fee: If the travel time to the patient’s location exceeds 30 minutes one-way, a travel time fee of R250 per hour will apply. This is calculated based on the time spent traveling to and from the patient's home.

 

3.6. Payment Due Date

• Payment Due On the Day of Consultation: Full payment for each consultation or treatment is due on the day of the appointment, whether you are paying privately or through medical aid. This includes any portion of the fee not covered by medical aid, such as co-payments, short payments, or out-of-pocket expenses.

 

3.7. Late or Unpaid Accounts

• Outstanding Payments: I understand that if payment is not made on the day of service, a late payment fee may be applied, and I will be responsible for any costs incurred in the collection of outstanding debts.

 

3.8. Non-Refundable Deposits

• Deposits: In certain cases (such as special procedures or treatments), Wound Well may require a non-refundable deposit to secure the booking, which will be applied towards the treatment cost.

3.9. No-Show and Cancellation Policy

• Cancellation: If I need to cancel or reschedule an appointment, I agree to notify Wound Well at least 24 hours in advance to avoid a no-show or late cancellation fee.

• No-Show: Failure to attend a scheduled appointment without prior notice will result in a no-show fee being charged.

4. Right to Refuse or Withdraw Consent
I understand that:

• I have the right to refuse or withdraw consent for any specific procedure or for all treatments at any time.

• If I withdraw consent, I understand the potential consequences and accept responsibility for the outcome.

 

5. Varying Treatment Outcomes

The patient understands that results of treatment may vary from person to person, and that not all wounds or medical conditions will heal at the same rate or in the same manner. The outcome of the treatment depends on multiple factors, including but not limited to the patient’s underlying health condition, adherence to treatment plans, lifestyle, comorbidities, and external environmental factors.
Best Efforts in Treatment

 

The healthcare provider, through Wound Well, will practice in accordance with the highest professional standards and provide care to the best of their abilities. This includes accurate assessment, diagnosis, and tailored treatment plans based on the individual needs of the patient. The treatment plan will be discussed thoroughly with the patient, including any potential risks, benefits, and alternative options.

 

No Guarantee of Results: While the healthcare provider strives for optimal results, no specific guarantee is made as to the speed or degree of healing of any wound or medical condition treated. The patient acknowledges that healing may take longer than anticipated or may not fully occur despite best efforts and appropriate care.

 

Patient Cooperation: The success of the treatment also relies heavily on the patient’s active participation and cooperation in adhering to the prescribed treatment plan, including wound care instructions, attending follow-up appointments, maintaining a healthy lifestyle, and following all guidance provided. Failure to comply with medical recommendations may impact the treatment outcome.

 

Exemption from Liability: The healthcare provider cannot be held liable for any unforeseen complications, lack of healing, or any adverse events arising from the treatment. The patient agrees to Wound Well, its staff, and practitioners harmless from any claims related to the treatment, provided that the treatment was administered in good faith, following recognized medical practices, and to the best of the provider's professional capacity.

5. Acknowledgment and Declaration
By attending our clinic for medical treatment, I confirm:

• I have read, understood, and agree to the terms outlined in this Consent for Medical Treatment and Payment Agreement.

• I Understand the potential risks associated with my treatment.

• I Understand the nature of treatment and potential for varying results and the conditions under which the healthcare provider cannot be held responsible for healing outcomes.

• I understand that I am financially responsible for payment at the time of consultation, and any portion not covered by medical aid is payable immediately.

• I agree to inform Wound Well of any changes to my medical aid status or payment information.

• I understand the travel fee applicable for home visits and the amount charged per kilometer.

• I have had the opportunity to ask questions about my treatment plan and payment obligations, and all questions have been answered to my satisfaction.