Public offer

Public Offer Agreement
for the Provision of Paid Medical Services

Republic of Kazakhstan, Aktobe April 23, 2024

1. GENERAL PROVISIONS

1.1. This public offer is addressed to individuals, as well as their legal representatives, wishing to receive medical services (Patients) at Ecomed-Aktobe Limited Liability Partnership, in accordance with Articles 387 and 395 of the Civil Code of the Republic of Kazakhstan.

1.2. Acceptance of this offer means that the Patient agrees to all provisions of this offer and is equivalent to entering into an Agreement for the provision of medical services pursuant to Article 387 of the Civil Code of the Republic of Kazakhstan.

1.3. The terms set forth in this offer constitute the terms of the public agreement for the provision of medical services at Ecomed-Aktobe LLP.

1.4. Ecomed-Aktobe LLP, hereinafter referred to as the “Clinic and/or Provider,” represented by its Director, acting on the basis of the Charter and a license to conduct medical activities, hereby expresses its intention to enter into an agreement for the provision of medical services with any individual, including citizens of the Republic of Kazakhstan, foreign citizens, and stateless persons, hereinafter referred to as the “Patient and/or Customer,” under the terms of this offer (hereinafter referred to as the “Agreement”).

1.5. The validity period of this offer is established as 5 (five) years.

1.6. This Agreement is a public offer agreement and contains all essential terms and conditions for the provision of medical services.

1.7. The terms of this Agreement are the same for all Patients/Customers.

1.8. Evidence of full and unconditional acceptance of the terms of this Agreement, as well as the date of conclusion of the Agreement, shall be the performance by the Patient/Customer of actions aimed at fulfilling the terms of the Agreement, in particular, receiving the service(s) and/or paying for them.

1.9. Acceptance by individuals wishing to accept this offer shall be made by performing any of the following actions:
— making an appointment with a specialist through the call center;
— actually receiving medical services;
— making the first payment for medical services.

2. SUBJECT OF THE AGREEMENT

2.1. Under this Public Offer for entering into an agreement for the provision of medical services to individuals (hereinafter referred to as the “Agreement”), the Clinic/Provider undertakes to provide the Patient/Customer with medical services (hereinafter referred to as “medical services”) within the scope of its activities, in accordance with the state licenses held for conducting medical activities and the applicable regulatory legal acts in the healthcare sector of the Republic of Kazakhstan. The Patient/Customer undertakes to pay for the services provided in a timely manner, comply with the requirements and recommendations of the Clinic’s specialists, and observe the Clinic’s internal regulations and rules of conduct. The list and cost of medical services provided to the Patient shall be determined by the Clinic’s price list in effect at the time the services are provided.

3. TERMS AND PROCEDURE FOR THE PROVISION OF SERVICES

3.1. The Clinic/Provider conducts its activities in accordance with the applicable legislation of the Republic of Kazakhstan:
— Constitution of the Republic of Kazakhstan;
— Civil Code of the Republic of Kazakhstan;
— Code of the Republic of Kazakhstan “On Public Health and Healthcare System” dated July 7, 2020 No. 360-VI;
— Entrepreneurial Code of the Republic of Kazakhstan dated October 29, 2015 No. 375-V;
— Code on Marriage (Matrimony) and Family dated December 26, 2011 No. 518-V;
— Order of the Minister of Healthcare of the Republic of Kazakhstan dated December 15, 2020 No. ҚР ДСМ-272/2020 “On Approval of the Rules and Conditions for the Use of Assisted Reproductive Methods and Technologies”;
— Order of the Minister of Healthcare of the Republic of Kazakhstan dated December 8, 2020 No. ҚР ДСМ-236/2020 “On Approval of the Rules and Conditions for Donation of Germ Cells and Tissues of Reproductive Organs”;
— Labor Code of the Republic of Kazakhstan dated November 23, 2015 No. 414-V;
— Code of the Republic of Kazakhstan “On Taxes and Other Mandatory Payments to the Budget” (Tax Code) dated December 25, 2017 No. 120-VI;
— Budget Code of the Republic of Kazakhstan dated December 4, 2008 No. 95-IV;
— Law of the Republic of Kazakhstan “On Permits and Notifications” dated May 16, 2014 No. 202-V;
— Law of the Republic of Kazakhstan “On Personal Data and Their Protection” dated May 21, 2013 No. 94-V;
— Law of the Republic of Kazakhstan “On Consumer Rights Protection” dated May 4, 2010 No. 274-IV;
— Law of the Republic of Kazakhstan “On Limited and Additional Liability Partnerships” dated April 22, 1998 No. 220-I;
— Law of the Republic of Kazakhstan “On Compulsory Social Health Insurance” dated November 16, 2015 No. 405-V;
— Law of the Republic of Kazakhstan “On Accounting and Financial Reporting” dated February 28, 2007 No. 234-III;
— Law of the Republic of Kazakhstan “On Combating Corruption” dated November 18, 2015 No. 410-V;
— Law of the Republic of Kazakhstan “On Languages in the Republic of Kazakhstan” dated July 11, 1997 No. 151-I;
— Resolution of the Government of the Republic of Kazakhstan dated October 16, 2020 No. 672 “On Approval of the List of the Guaranteed Volume of Free Medical Care and Recognition of Certain Decisions of the Government of the Republic of Kazakhstan as Invalid”;
— Order of the Minister of Healthcare of the Republic of Kazakhstan dated October 29, 2020 No. ҚР ДСМ-170/2020 “On Approval of the Rules for the Provision of Services by Healthcare Entities and the Standard Form of Agreement for the Provision of Paid Medical Services (Care).”

3.2. Place of provision of medical services: 15 Akkagaz Doszhanova St., Astana District, Aktobe.

3.3. The Patient agrees that treatment provided by the Clinic cannot fully guarantee the achievement of the desired result, since various complications may occur during or after the provision of services, both in the short and long term. The Patient also acknowledges that the medical technologies used cannot completely eliminate the possibility of side effects and complications caused by the biological characteristics of the human body.

3.4. The Clinic/Provider provides services under this Agreement during its established business days and hours. Appointments are scheduled daily during the Clinic’s business hours for available time slots on any date, subject to the Clinic’s operating hours and the schedule of the relevant specialist.

Call center operating hours:
Monday–Friday: 08:00–20:00,
Saturday: 08:00–14:00,
Sunday: 08:00–15:00.

Outside the Clinic’s business hours, online appointment requests are accepted only through the website.

Such requests are processed during the first working hours of the call center operators.

Current telephone numbers are also published on the Clinic’s official online resource.

3.5. All specialist appointments are made in advance:
— through the Clinic’s website http:// www.ecomed.kz after completing the online appointment request form;
— by calling the call center at +7 775 007 07 00;
— through administrators directly at the Clinic’s reception desk.

Patients may be seen by a physician without a prior appointment subject to approval by the Clinic’s reception desk or call center.

3.6. All incoming calls are handled by the call center, and all conversations with call center operators are recorded.

3.7. The duration of an appointment depends on the physician’s specialization and the type of appointment (initial/follow-up consultation, examination, or other services).
► An initial consultation may last from 30 (thirty) to 40 (forty) minutes. Within this range, the duration of each appointment is determined by the specialist.
► A follow-up consultation may last from 20 (twenty) to 30 (thirty) minutes. Examinations may last from 15 (fifteen) to 20 (twenty) minutes.
► The duration of diagnostic examinations depends on the specific type of examination and may be up to 15 (fifteen) working days.

If emergency care must be provided to another Patient in serious condition or another Patient requires an urgent examination, the appointment time may be changed.

Patients are seen by physicians according to schedules established by the Clinic. Physicians’ schedules may vary. A physician has the right to interrupt an appointment in order to provide emergency medical care to another Patient.

3.8. Booking an appointment through the website. To submit an online appointment request through the website, the Patient must complete the relevant form and wait for a call from a call center operator confirming the appointment. If the request has not been confirmed within 24 hours during the call center’s business hours, a technical failure may have occurred, and the Patient should resubmit the request or contact the call center by telephone.

More detailed information can be obtained by contacting the call center or the reception desk.

3.9. If a Patient with an infectious disease visits the Clinic and an initial diagnosis of an infectious disease is established or such a disease is suspected, the Patient shall be referred to a specialized medical institution.

3.10. To maintain order and ensure safety, video surveillance is conducted in the halls and corridors of the Center in accordance with the Rules for the Use of Technical Monitoring Devices, Surveillance and Recording Devices, and Photo and Video Equipment in Medical Organizations for the Protection of the Rights of Patients and Healthcare Professionals, approved by the authorized body.

3.11. The Patient must carry an identity document and provide personal data, including full name, age, residential address, and contact telephone numbers. When receiving ART (assisted reproductive technology) services, the Patient must also provide documents confirming marital status and all other documents required for treatment and the provision of services.

3.12. Payment shall be made at the Center’s cashier’s office either in cash or by bank card to the Clinic/Provider’s bank account.

The conditions for providing medical services to citizens (Patients) referred by legal entities include: a signed agreement; advance payment; an application; a referral; and an identity document of the referred Patient.

3.13. In the event of an unforeseen absence of a physician or other emergency circumstances, a call center specialist (administrator) shall notify the Patient as soon as reasonably possible.

3.14. If the Patient is unable to attend the appointment at the agreed time, the Patient undertakes to notify the Clinic by telephone as soon as possible.

3.15. The Clinic has the right to refuse to provide services to a Patient even if an appointment has been scheduled in advance if the Patient arrives more than 15 (fifteen) minutes late. A physician may postpone a Patient’s scheduled appointment to a later time if necessary to complete medical care for the preceding Patient, but by no more than 1 (one) hour. A physician may change the order in which Patients are seen, even where appointments have been scheduled in advance, if this is necessary to see a Patient in a more serious condition or to reduce other Patients’ contact with a Patient suffering from a respiratory infectious disease. If a physician’s appointment is canceled due to the physician’s health condition, the Clinic shall promptly notify the Patients scheduled to see that physician; however, the Clinic is not required to provide a replacement physician.

3.16. If the Patient/Customer is late for the scheduled time for receiving a medical service, the Clinic/Provider reserves the right to shorten the duration of the medical service or cancel it entirely without refunding or recalculating the amount paid for the service.

3.17. Where diagnostic procedures (including aspiration, biopsy, injections, etc.) or surgical interventions are required, the Patient (or the Patient’s legal representative) undertakes to sign informed consent for such procedures or formally refuse them.

3.18. If Patients visit the Clinic and there are sufficient grounds to believe that harm to their health was caused by unlawful actions, the Clinic shall provide the relevant information to the law enforcement authorities of the Republic of Kazakhstan at the location of the medical organization.

3.19. The Patient must arrive 10 (ten) minutes before the scheduled appointment and carry an identity document for preparation of medical records. In accordance with Order No. ҚР ДСМ-175/2020 of the Acting Minister of Healthcare of the Republic of Kazakhstan dated October 30, 2020 “On Approval of Forms of Record-Keeping Documentation in the Field of Healthcare,” the Patient must provide personal data, including full name, Individual Identification Number (IIN), age, residential address, and contact telephone number, both when visiting the Clinic and when making an appointment in advance.

3.20. If the Patient is unable to attend an appointment at the agreed time, the Patient undertakes to notify the Clinic by telephone as soon as possible. A specific amount of appointment time is allocated to each Patient according to the schedule. Late arrival or delays may reduce the quality of the service provided and cause delays for the next Patient.

3.21. If a Patient is late by more than 30% of the allocated appointment time, the physician reserves the right to reschedule the appointment if it cannot be extended without adversely affecting subsequent Patients.

3.22. The Patient may enter the office of a physician or other Clinic personnel only upon invitation. Entering a Clinic staff member’s office without invitation while an appointment is in progress is prohibited. Such conduct shall be regarded as a violation of the Clinic’s internal regulations and as disrespectful not only to Clinic personnel but also to other Patients.

3.23. The Patient is informed that failure to comply with the instructions (recommendations) of the Clinic’s medical personnel may reduce the quality of the medical service provided, make it impossible to complete the service within the prescribed period, or adversely affect the Patient’s health.

3.24. If the Patient violates the Clinic’s internal regulations or rules of conduct, obstructs the lawful activities of healthcare professionals, shows disrespect toward Clinic personnel, including making negative statements about the Clinic’s physicians or personnel, behaves rudely toward personnel, fails to comply with instructions, recommendations, or prescriptions of medical personnel, or in the event of psychological incompatibility manifested by a medical conflict between the Patient and the physician, the Clinic has the right to withdraw from this Agreement from the moment such violations are identified, provided that discontinuation of medical services does not threaten the Patient’s life or the health of others. The cost of services actually provided shall not be refunded.

3.25. The Patient undertakes to observe the rules of personal hygiene.

3.26. During epidemics (acute respiratory viral infections and others), it is recommended to maintain social distancing and use personal protective equipment, including gauze or other masks intended to protect against respiratory infections.

3.27. Before each invasive procedure, the Patient shall sign an informed consent form after reviewing its contents.

3.28. Medical reports concerning the Patient’s health that contain information about the diagnosis, the Patient’s condition, recommendations, and prescriptions for treatment and prevention are the property of the Clinic if they were provided to the Patient by Clinic medical personnel during their working hours. The Patient has the right to provide such medical reports to healthcare professionals at other medical organizations for the purpose of receiving medical care. Under this Agreement, the Patient and other persons are prohibited from publishing the Patient’s medical reports in mass media, social media, or online communication services, or showing them to third parties without prior coordination with the Clinic, unless otherwise provided by the legislation of the Republic of Kazakhstan.

3.29. Clinic personnel have the right to refuse to provide services to the Patient if the Patient fails to comply with the rules of conduct set forth in this Agreement.

3.30. During visits to the Clinic, Patients and accompanying persons must treat the Clinic’s property with care. If any property is damaged (destroyed, spoiled, damaged, etc.), the responsible person shall voluntarily compensate the Clinic for the damage within 7 (seven) working days from the date a claim is submitted, or the administration has the right to recover the damages from the responsible person in accordance with the procedure established by law.

3.31. The Patient agrees that treatment provided by the Clinic cannot fully guarantee achievement of the desired result, since various complications may occur during or after the provision of medical services, both in the short and long term. The Patient also acknowledges that the medical technologies used cannot completely eliminate the possibility of side effects and complications caused by the biological characteristics of the human body.

3.32. Internal regulations and rules of conduct at the Clinic. While visiting or remaining on the premises of the medical institution, it is prohibited to:
— interfere with the attending physician’s actions or perform other actions that disrupt the process of providing medical care;
— behave disrespectfully toward other Patients or Clinic employees;
— damage Clinic property;
— disturb the peace and order in the Clinic, make excessive noise, slam doors, etc.;
— use a mobile telephone during appointments or medical procedures;
— use obscene language, insult or behave rudely toward Clinic personnel or other persons present at the Clinic, or engage in disputes with them in the presence of others;
— insult or offend the honor and dignity of Clinic employees or other Patients, threaten them, or exert pressure on Clinic personnel or other Patients.

3.33. While on the premises of the Clinic and the adjacent territory, the Patient, the Patient’s legal representative, and accompanying persons are strictly prohibited from:
— consuming alcoholic beverages or other narcotic or intoxicating substances, or smoking on the porch or anywhere inside the Clinic;
— throwing litter, cigarette butts, personal hygiene products, shoe covers, other medical supplies, or used medications on the floor.

3.34. In the event of improper, unacceptable, or aggressive behavior by the Patient, the Patient’s legal representatives, or accompanying persons, including violent or disorderly conduct, abusive statements toward medical personnel, or being under the influence of alcohol or narcotic substances, the Clinic administration reserves the right to refuse further observation and treatment of the Patient.

3.35. Cleanliness and order must be maintained on the Clinic premises. Waste and used personal hygiene products must be disposed of only in designated waste bins. Used shoe covers must be placed in the special bin located in the Clinic lobby.

3.36. During an epidemiological situation, the Patient, the Patient’s legal representative, and accompanying persons are advised to use personal protective equipment, including gauze or other masks intended to protect against respiratory infections.

3.37. The Clinic’s management and personnel have the right to refuse service, observation, treatment, and provision of medical services to a Patient who fails to comply with the above internal regulations and rules of conduct.

4. PAYMENT PROCEDURE

4.1. Services must be paid for in full at the cashier’s office on the day the service is provided, before the initial/follow-up consultation with the specialist. Payment may be made in cash or by cashless payment.

An initial consultation means the first visit to a particular medical specialist within one month.

A follow-up consultation includes all subsequent visits by the Clinic Patient to the same medical specialist within the same month.

4.2. The cost of paid medical services provided to the Patient/Customer shall be determined in accordance with the Clinic/Provider’s price list for paid medical services in effect at the time the Patient seeks care.

4.3. Medical services shall be paid for in full by the Patient/Customer personally (or, with the Patient’s consent, by another person) on the day the services begin, in accordance with the current price list.

4.4. If the Patient/Customer reasonably refuses an examination or treatment by submitting a written application addressed to the head of the Clinic, the amount paid for medical services shall be refunded to the Patient/Customer upon presentation of the Patient’s identity document and receipt, except in cases provided for by a separate agreement entered into between the Clinic and the Patient.

4.5. If a service is terminated early, the Clinic/Provider shall refund to the Patient/Customer the difference between the amount paid and the cost of services actually provided, except where the Patient/Customer has violated the terms of the Agreement.

4.6. The Patient must pay for the Clinic’s services before receiving them. If additional services are prescribed by the Clinic’s medical personnel during the provision of medical care, the Patient undertakes to pay for such services after receiving them, but no later than 30 (thirty) minutes after they are provided. Payment may be made in cash or by cashless payment.

4.7. Payment for the Clinic’s services shall be made exclusively in the national currency of the Republic of Kazakhstan in accordance with the Law of the Republic of Kazakhstan “On Currency Regulation and Currency Control.”

5. RIGHTS AND OBLIGATIONS OF THE CLINIC/PROVIDER

5.1. When providing medical services, the Clinic/Provider shall:

5.1.1. Provide medical services in accordance with the applicable healthcare legislation of the Republic of Kazakhstan, the licenses held by the Clinic/Provider, established procedures for the provision of medical care, and applicable standards of medical care;

5.1.2. Comply with regulatory legal acts in the healthcare sector;

5.1.3. Provide the Patient/Customer with an opportunity to review the price list in effect during the period in which medical services are provided under this Agreement;

5.1.4. Ensure that medical services are provided in accordance with clinical protocols for the diagnosis and treatment of diseases and, where no clinical protocols exist, in accordance with generally accepted approaches and evidence-based medicine, based on medical indications;

5.1.5. Ensure that medical care is provided free of charge where, during the provision of paid medical services, additional emergency medical services are required to eliminate a threat to the Patient’s life arising from sudden acute diseases, conditions, exacerbations, or chronic diseases, in accordance with the Code of the Republic of Kazakhstan dated July 7, 2020 “On Public Health and Healthcare System” (hereinafter referred to as the “Code”);

5.1.6. Provide the Patient, free of charge, with accessible and reliable information including the Clinic’s location (place of state registration), operating hours, list of medical services provided, and the terms and conditions for providing and receiving such services.

5.1.7. Inform and notify the Patient:
— if certain types of services cannot be provided;
— if emergency or planned inpatient treatment of the Patient must be arranged;
— of contraindications and possible adverse consequences associated with a particular type of service;
— of unilateral termination of the Agreement in the event of a violation of internal regulations or rules of conduct.

5.1.9. Ensure that the Patient has direct access to medical records reflecting the Patient’s health condition and, upon written request from the Patient or the Patient’s legal representative, provide copies of medical documents reflecting the Patient’s health condition;

5.1.10. Provide the Patient with medical documentation and medical reports on the Patient’s health condition indicating the examinations performed and therapeutic measures taken, in accordance with the legislation of the Republic of Kazakhstan.

5.1.11. Maintain the necessary sanitary, hygienic, and anti-epidemic conditions on its premises when providing medical services;

5.1.12. Promote compliance by personnel with the Code of Honor.

5.1.13. Treat the Patient/Customer respectfully and humanely;

5.1.14. Provide medical services of appropriate quality, using modern diagnostic and treatment methods, in full accordance with this Agreement after the Patient/Customer has paid the required amount in accordance with Section 4 of this Agreement and provided documents confirming payment;

5.1.15. Maintain records of the types, volumes, and costs of medical services provided to the Patient/Customer, as well as payments received from the Patient/Customer.

5.2. When providing medical services, the Clinic/Provider has the right to:

5.2.1. Independently determine the scope of medical services required for diagnosis and treatment, guided by clinical diagnostic and treatment protocols, procedures and standards of medical care approved by the Ministry of Healthcare of the Republic of Kazakhstan or, where relevant clinical protocols are unavailable, by the experience of its physicians, generally accepted approaches, and evidence-based medicine based on medical indications and the capabilities of the clinical facilities.

5.2.2. Engage third parties (co-providers) to perform its obligations under this Agreement.

5.2.3. Unilaterally terminate treatment early if medical prescriptions are not followed or if the Patient/Customer violates the prescribed regimen, the rules for staying at the Clinic, or the Clinic’s internal regulations.

5.2.4. Refrain from providing paid services until the Patient has fulfilled the obligation to pay for the medical services.

5.2.5. Refuse to provide services:
— if contraindications to therapeutic or diagnostic procedures are identified in the Patient;
— if the Patient fails to comply with the Clinic’s recommendations;
— if the Patient refuses to complete/sign documents required for the provision of particular types of services (voluntary informed consent to medical intervention, etc.);
— if the Patient violates the Clinic’s internal regulations or the rules of conduct set forth in this Agreement;
— if it is impossible to ensure the safe provision of the medical service.

5.2.6. If the Patient/Customer refuses services that, in the opinion of the Clinic/Provider, could reduce or eliminate a risk to the Patient/Customer’s health, obtain a written acknowledgment of refusal of medical care from the Patient/Customer after explaining the possible consequences of such refusal for the Patient/Customer’s health.

5.2.7. Change the time at which services are provided subject to prior agreement with the Patient, see a Patient with symptoms of an acute illness without waiting in the regular queue, and replace the attending physician;

5.2.8. If the Patient arrives more than 15 (fifteen) minutes after the scheduled service time, reschedule or cancel the Patient’s appointment;

5.2.9. Store and process Patients’ personal data and use such data in anonymized form in accordance with the law.

5.2.10. Provide medical care without the Patient’s consent in cases provided for by the Health Code of the Republic of Kazakhstan.

6. RIGHTS AND OBLIGATIONS OF THE PATIENT/CUSTOMER

6.1. The Patient/Customer undertakes to:

6.1.1. Comply with the Clinic’s internal regulations and rules of conduct for Patients, as well as the rules established by Ecomed-Aktobe LLP.

6.1.2. Timely and accurately follow medical prescriptions, instructions, and recommendations of the attending physician and relevant specialists regarding treatment and examinations; comply with the Clinic/Provider’s internal regulations, therapeutic and protective regimen, safety regulations, and fire safety requirements;

6.1.3. Cooperate with the physician (medical personnel) at all stages of medical care.

6.1.4. During the term of this Agreement, refrain from self-treatment, following recommendations from or receiving treatment from healers, alternative medicine practitioners, or physicians of other medical organizations without first coordinating such actions with the attending physician;

6.1.5. Treat healthcare professionals and other persons involved in the provision of medical care with respect and respect the rights of other Patients.

6.1.6. Familiarize themselves with the procedure and conditions for the provision of medical services under this Agreement;

6.1.7. Pay the cost of medical services before they are provided, in accordance with the price list approved by the Clinic/Provider and the procedure established in Section 4 of this Agreement, exclusively through the Clinic/Provider’s cashier’s office;

6.1.8. Provide the person rendering medical care with the necessary and accurate information required to ensure the proper provision of medical services, including personal data; information about the Patient’s health and the health of close relatives; medical history; hereditary, previous, or current diseases; infections; surgeries; possible contraindications, including contraindications to medicinal products; individual characteristics of the body; harmful habits and occupational hazards; allergic reactions; and other necessary documents. The Patient must also provide the results of previous examinations and consultations conducted outside the Clinic/Provider, if available, and all other known information regarding the Patient’s health and other factors that may affect the course of treatment.

6.1.9. The Patient must understand that deliberate misrepresentation of information concerning their health may affect the accuracy of the diagnosis and prescribed treatment and may influence the prognosis for recovery.

6.1.10. The Patient must immediately notify the attending physician of any deterioration in health, report any changes in well-being during treatment, and immediately inform the physician of any adverse situations that may have caused harm to the Patient’s health;

6.1.11. If the attending physician is unavailable, provide this information to an employee of the Clinic’s reception desk or call center.

6.1.12. Provide contact information (email address, telephone numbers, actual residential address), personal data, and, where necessary, information and documents confirming marital status;

6.1.13. If refusing services that, in the opinion of the Clinic/Provider’s physicians, could reduce or eliminate a risk to the Patient/Customer’s health, provide a written acknowledgment of refusal of medical care;

6.1.14. If the Patient/Customer fails to attend and/or arrives more than 15 (fifteen) minutes late for the scheduled service, the Clinic/Provider reserves the right to reschedule or cancel the service.

6.1.15. If the Patient conceals or provides incomplete information regarding their health, the Clinic/Provider shall not be responsible for the outcome of treatment;

6.1.16. During epidemics or quarantine, observe social discipline and use protective equipment, including gauze or other masks intended to protect against respiratory infections.

6.1.17. Treat the Clinic’s property with care.

6.1.18. Comply with the rules set forth in this Agreement.

6.2. When seeking and receiving medical care, the Patient has the right to:

6.2.1. Choose an attending physician from among those working in the department and request transfer to another attending physician where an appropriate alternative is available;

6.2.2. Respectful treatment by Clinic employees and other persons involved in providing medical care.

6.2.3. Request from the Clinic/Provider the necessary medical information and supporting documents regarding the Patient’s health condition.

6.2.4. Request additional explanations from the Clinic/Provider regarding the Patient’s health condition and proposed diagnostic and treatment methods if previously provided explanations were unclear.

6.2.5. Receive information about the surname, first name, patronymic, position, professional experience, and qualification level of the attending physician and other persons directly involved in providing medical care;

6.2.6. Receive examination and treatment under conditions that comply with sanitary, hygienic, and anti-epidemic requirements;

6.2.7. Provide voluntary informed consent to medical intervention in accordance with applicable legislation;

6.2.8. The Patient or the Patient’s legal representative has the right to refuse medical intervention or demand its termination, except in cases provided for by law. In the event of refusal, the Patient or legal representative must be informed in an accessible manner of the possible consequences. The refusal of medical intervention, including an indication of possible consequences, shall be documented in the medical records and signed by the Patient or legal representative and by a healthcare professional;

6.2.9. Contact the Internal Audit and Patient Support Service, Clinic officials, supervisory and/or regulatory authorities, or a court;

6.2.10. Non-disclosure by Clinic personnel outside the Clinic of information concerning the fact that the Patient sought medical care, the Patient’s health condition, diagnosis, and other information obtained during examination and treatment, except in cases provided for by legislation.

6.2.11. Receive, in an accessible form, complete information regarding the Patient’s health condition and the diagnostic and treatment methods used, including examination results, the presence of disease, diagnosis and prognosis, treatment methods and associated risks, possible medical intervention options and their consequences, and treatment results; information regarding possible risks and benefits of proposed and alternative treatment methods; possible consequences of refusing treatment; diagnosis, prognosis, and treatment plan; explanations of the reasons for discharge home or transfer to another medical organization; as well as an independent medical opinion regarding the Patient’s health condition and a medical consultation by a panel of specialists.

6.2.14. The Patient may designate a person to whom information about the Patient’s health condition should be disclosed. Taking into account the Patient’s health condition, information about the Patient’s health may be withheld from the Patient and communicated to the Patient’s spouse, close relatives, or legal representatives.

7. CONFIDENTIALITY

7.1. For the purpose of performing this Agreement, in accordance with Articles 7 and 8 of the Law of the Republic of Kazakhstan “On Personal Data and Their Protection” dated May 21, 2013 No. 94-V, the Patient provides the Clinic with personal data, including surname, first name, patronymic, date of birth, identity document details, Individual Identification Number, registered address and residential address, contact details, documents confirming marital status where necessary, and other information, and consents to the processing by Clinic personnel of such personal data as well as special personal data relating to the Patient’s health for the purpose of receiving services provided by the Clinic. This consent covers any actions involving the Patient’s personal data that are necessary to achieve the above purposes, including, without limitation: collection, systematization, accumulation, storage, clarification (updating, modification), use, dissemination (including transfer), anonymization, blocking, destruction, and any other actions involving personal data permitted under applicable law. The Patient also consents to photo, video, and audio recording at the Clinic. Personal data shall be processed by the Clinic using automated processing tools and without the use of automated processing tools (non-automated processing).

7.2. The Parties undertake mutual obligations to keep confidential any information received from the other Party during performance of this Agreement.

7.3. The Parties shall ensure that access to such information is granted only to persons directly involved in fulfilling obligations under the Agreement.

7.4. The Parties undertake not to disclose to third parties not involved in providing the Services, and not to use for purposes other than proper performance of obligations under the Agreement, any information received from the other Party pursuant to or in connection with the Agreement without the written consent of the Party that provided such information, except for information that had already been obtained by the receiving Party before receiving it under the Agreement;

7.5. Transfer of information to third parties or any other disclosure outside the Clinic of information deemed confidential under this Agreement may take place only after obtaining the written consent of the other Party, except where such consent is not required by law.

7.6. With the consent of the Patient or the Patient’s representative, information constituting medical confidentiality may be disclosed to persons outside the Clinic, including officials, in the interests of the Patient’s examination and treatment, except where such consent is not required by law.

7.7. Information contained in the Patient’s medical records and constituting medical confidentiality may be provided without the consent of the Patient or the Patient’s representative for the purpose of examining and treating a Patient who, due to their condition, is unable to express their wishes, and in other cases provided for by the legislation of the Republic of Kazakhstan.

7.8. The results of medical examinations shall be communicated by Clinic personnel to Patients either personally, through mobile or other applications, or by electronic means of communication, strictly upon the Patient’s request using the contact information specified by the Patient during registration.

7.9. The Patient/Customer provides consent to the processing of personal data and informed consent to the provision of services at the Clinic’s reception desk by signing on an automated device using an electronic digital signature (EDS) key or by another method not prohibited by law.

7.9.1. By signing this Agreement, the Patient/Customer accepts its terms and consents to the Clinic/Provider processing their personal data.

7.9.2. By signing this Agreement, the Patient/Customer consents to audio, photo, and video recording on the premises of the Clinic/Provider, as well as to the publication of audio, photographic, and video materials on the Clinic/Provider’s official website. 7.10.3. I have read and accept the terms of the Public Agreement for the Provision of Medical Services and confirm the conclusion of the Public Agreement for the Provision of Medical Services published on the Clinic/Provider’s website http://www.ecomed.kz.

8. LIABILITY

8.1. A Party that fails to perform or improperly performs its obligations under this Agreement shall be liable in accordance with the applicable legislation of the Republic of Kazakhstan.

8.2. The Clinic shall be released from liability for failure to perform or improper performance of this Agreement where such failure results from the Patient’s violation of the terms of this Agreement, as well as on other grounds provided for by the legislation of the Republic of Kazakhstan.

8.3. The Clinic shall not be liable for consequences associated with documents (including personal documents) and/or information provided by the Patient if such documents or information are inaccurate, forged, incomplete, or otherwise unreliable.

8.4. The Clinic/Provider shall not be liable for the quality of medical services in cases where the Patient/Customer provides incomplete information regarding their health or where the relevant circumstances are caused by medical indications.

8.5. The Clinic/Provider shall not be liable for harm caused to the Patient/Customer’s health or for failure to achieve recovery if such circumstances resulted from the Patient/Customer’s failure to comply with medical prescriptions.

8.6. If the Patient/Customer fails on 2 (two) or more occasions to comply with the recommendations and requirements of the Clinic’s medical personnel, or violates the Clinic’s internal regulations, the Clinic has the right to terminate this Agreement unilaterally and without recourse to court and to discontinue the provision of medical services.

8.7. A Party that believes its rights under this Agreement have been violated may send the other Party a written claim describing its grievances. The Party receiving the claim shall respond in accordance with the procedure established by law.

8.8. The Clinic shall not be liable for the outcome of services provided in the following cases:
— failure by the Patient to comply with treatment recommendations or other actions by the Patient aimed at worsening their health;
— provision of services at the Patient’s insistence in the absence of medical indications;
— failure to complete the treatment plan due to the Patient’s failure to attend or refusal to continue treatment;
— occurrence of previously unreported allergies or intolerance to medicinal products or medical devices approved for use;
— medical intervention by third parties after the Clinic has provided its services;
— the Patient’s informed refusal to continue treatment where the Patient was warned that the medical services actually provided in such circumstances may be ineffective;
— deterioration of the Patient’s subsequent health condition or complications associated with refusal of treatment as a whole or individual medical interventions;
— occurrence of side effects from medicinal products and preparations where the possibility of such side effects was indicated by the manufacturer in the relevant product information;
— failure by the Patient to inform the physician about previous diseases, allergic reactions, or contraindications where the ineffectiveness of the medical service or harm caused resulted from the physician’s lack of such information.

8.9. The Clinic/Provider shall be responsible for the proper scope and quality of services.

8.10. The Parties shall be released from liability for partial or complete failure to perform, or improper performance of, their obligations under this Agreement if such failure results from force majeure or other circumstances beyond their reasonable control, including natural disasters, epidemics, military actions, strikes, decisions adopted by competent authorities, etc., that prevent performance of obligations under this Agreement.

8.11. The Patient/Customer shall bear responsibility for obstructing the lawful activities of medical and/or pharmaceutical professionals, violating quarantine requirements, sanitary rules and hygienic standards, and committing administrative offenses affecting public order and morality in the Republic of Kazakhstan, for which fines and other liability may be imposed. The Patient/Customer shall also bear responsibility for disseminating information that defames and/or discredits the Clinic/Provider and/or its clients in mass media, social networks, and/or other mass communication systems, including messengers and chats, in connection with the Services.

8.12. If the Patient/Customer violates the terms of payment for medical services, the Clinic/Provider may impose applicable penalties. If the Patient has outstanding debts for services already provided by the Clinic, the Clinic has the right to suspend further provision of services under this Agreement until the Patient has paid in full for services already provided.

8.13. If the Patient causes damage to the Clinic’s property, the Patient must compensate for such damage in full.

8.14. In all other cases, the Parties shall bear liability in accordance with the applicable legislation of the Republic of Kazakhstan.

9. AMENDMENT OF THE AGREEMENT

9.1. The terms of this Agreement may be amended unilaterally by the Clinic/Provider. Amendments to the Agreement shall be published online on the Clinic/Provider’s website and made available in hard copy at the Clinic’s reception desk. Amendments shall enter into force from the moment they are made publicly available. In the event of discrepancies between versions, the version available at the Clinic’s reception desk shall prevail.

10. TERM OF THE AGREEMENT

10.1. This Public Offer Agreement enters into force on the date of its public posting and remains valid until January 3, 2027, specifically until the Parties have fully performed their obligations or the Agreement is terminated. Under the terms of the Agreement, if its conditions are violated, the Clinic has the right to terminate it unilaterally by sending written notice to the other Party. Accordingly, termination of the Agreement does not require the mandatory execution of a separate termination agreement or written confirmation of consent to termination by the other Party. The Agreement shall be deemed terminated from the moment the notice is sent to the Patient.

11. PROCEDURE FOR RESOLVING DISPUTES AND CONFLICT SITUATIONS

11.1. The procedure for reviewing cases (events) involving medical incidents, as well as their recording and analysis, shall be determined on the basis of an order approved by the authorized healthcare authority.

11.2. If the Patient’s rights are violated, the Patient (or the Patient’s legal representative) may submit a written claim through the reception desk for consideration by the head of the Clinic. A claim may also be entered in the feedback and suggestions book or submitted electronically through the Clinic’s website. To receive a prompt response, the Patient is advised to provide a contact telephone number to the Internal Audit and Patient Support Service. The request shall be reviewed in accordance with the procedure established by law.

11.3. A claim shall be reviewed within 3 (three) to 20 (twenty) working days from the date it is received by the Clinic. A written response shall be sent to the Patient by mail to the address provided by the Patient or, at the Patient’s request, may be delivered personally at an agreed time or explained verbally. A response to a claim submitted through the Clinic’s website shall be sent electronically to the email address provided by the Patient.

11.4. For any questions, complaints, or suggestions, the Patient may contact the Internal Audit and Patient Support Service or the head of the Clinic.

11.5. The Parties undertake to resolve all disputes arising under this Agreement through negotiations between the Parties and/or their representatives, as well as through mediation. Any disputes that cannot be resolved by the Parties in connection with the performance of this Agreement shall be resolved in accordance with the applicable legislation of the Republic of Kazakhstan.

12. PRICING POLICY

12.1. The cost of services, except for services provided under a state order, shall be determined independently by the Clinic and specified in the Clinic’s price list approved by order of the Clinic Director. Information regarding the prices of Clinic services published on the official website shall always correspond to the information contained in the Clinic’s price list.

12.2. The Clinic does not provide discounts on its services on social grounds, including disability, retirement age, or having a large family.

12.3. The Clinic may provide discounts on individual services or all services as part of temporary promotional campaigns, information about which may be published on the website, through the Clinic’s social media accounts, at the reception desk, or by any other means. The Clinic has the right to provide discounts to individual Patients based on their written request accompanied by official supporting documents, subject to review by the Clinic Director.

13. FORCE MAJEURE

13.1. A Party shall be released from liability for partial or complete failure to perform, or improper performance of, an obligation if such failure results from force majeure circumstances arising after conclusion of the Agreement due to extraordinary circumstances that the Party could neither foresee nor prevent.

13.2. For the purposes of this Agreement, “force majeure” means an event beyond the control of the Parties and of an unforeseeable nature. Such events may include, but are not limited to: war, military actions, natural disasters, floods, fires, earthquakes, epidemics, and decisions of state authorities or administrative bodies.

13.3. The Parties acknowledge that insolvency of either Party does not constitute a force majeure circumstance.

13.4. The Parties shall not be liable for failure to perform the terms of the Agreement if such failure results from force majeure circumstances.

13.5. The Clinic/Provider shall not be liable for payment of penalties or termination of the Agreement due to failure to perform its terms if a delay in performance results from force majeure circumstances.

13.6. If force majeure circumstances arise, the Clinic/Provider must immediately send the Patient/Customer written notice describing such circumstances and their causes. Unless the Patient/Customer provides other written instructions, the Clinic/Provider shall continue performing its obligations under the Agreement to the extent reasonably practicable and shall seek alternative means of performing the Agreement that are not affected by the force majeure circumstances.

14. PROCEDURE FOR PROVIDING INFORMATION ABOUT THE PATIENT’S HEALTH CONDITION

14.1. Every citizen has the right to receive, in an accessible form, available information about their health condition, including examination results, the presence of disease, diagnosis and prognosis, treatment methods and associated risks, possible options for medical intervention, their consequences, and the results of treatment provided.

14.2. Information regarding the Patient’s health condition shall be provided in an accessible form consistent with the requirements of medical ethics by the attending physician or other Clinic officials. The information must include examination results, the presence of disease, diagnosis and prognosis, examination and treatment methods and associated risks, possible options for medical intervention and their consequences, as well as the results of treatment and possible complications. Information about a person’s health condition may not be provided against that person’s wishes. In cases of an unfavorable prognosis, the information must be communicated sensitively to the person and members of their family unless the person has prohibited disclosure to them and/or designated another person to whom such information should be communicated.

14.3. For minors under the age of 18 and persons legally declared incapable in accordance with the established procedure, information regarding the Patient’s health condition shall be provided to their legal representative.

14.4. Information contained in medical records constitutes medical confidentiality and may be provided without the consent of the Patient or the Patient’s legal representatives only on the grounds provided for by applicable law.

15. PROCEDURE FOR ISSUING CERTIFICATES OF TEMPORARY INCAPACITY FOR WORK, CERTIFICATES, AND EXTRACTS FROM MEDICAL RECORDS TO THE PATIENT AND/OR OTHER PERSONS

15.1. The procedure for issuing documents certifying temporary incapacity for work, as well as extracts from medical records, is governed by applicable law.

15.2. Temporary incapacity for work shall be certified by a certificate of temporary incapacity for work in the prescribed form, the procedure for issuing which is approved by Order of the Minister of Healthcare of the Republic of Kazakhstan dated November 18, 2020 No. ҚР ДСМ-198/2020 “On Approval of the Rules for Conducting an Examination of Temporary Incapacity for Work and Issuing a Certificate or Statement of Temporary Incapacity for Work.”

15.3. When an embryo transfer is performed, the certificate and statement of temporary incapacity for work shall be issued by the medical organization that performed the procedure.

15.4. At the Patient’s request, a medical certificate or an extract from the medical record may be issued. A copy of the medical record may be issued upon the Patient’s written application.

16. Final Provisions

16.1. Without contradicting the terms of this Offer, the Patient/Customer and the Clinic/Provider have the right at any time to execute an agreement for the provision of paid medical services in the form of a bilateral written document.

16.2. This Agreement is concluded through the Patient/Customer’s acceptance of the Clinic/Provider’s public offer and remains valid until the Parties have fully performed their respective obligations. The Clinic/Provider reserves the right to amend the terms of the offer or withdraw the offer at any time at its discretion, subject to mandatory notification of the Patient/Customer no later than 5 (five) working days before such amendments or withdrawal enter into force.

16.3. The Patient/Customer agrees and acknowledges that amendments to the offer result in corresponding amendments to the Agreement concluded and in force between the Parties, and such amendments to the Agreement enter into force simultaneously with the relevant amendments to the offer. The Patient/Customer hereby confirms that they possess all legal rights and authority necessary to enter into the Agreement.

16.4. The Patient/Customer’s request for or receipt of services after amendments have been made to the Agreement (public offer) shall be unambiguously understood by both the Clinic/Provider and the Patient/Customer as acceptance of such amendments.

16.5. The terms of this Agreement may be amended unilaterally by the Clinic/Provider. Amendments shall be published online on the Clinic/Provider’s website and/or made available in hard copy at the Clinic/Provider’s location. Amendments shall enter into force from the moment they are publicly posted.

16.6. In all matters not governed by this Agreement, the Parties shall be guided by the applicable legislation of the Republic of Kazakhstan.

17. DETAILS AND SIGNATURES OF THE PARTIES

17.1. The Parties unconditionally agree that the Patient/Customer’s details shall be deemed to be the information provided when making an appointment for a physician consultation and examination.

17.2. Clinic/Provider:
Ecomed-Aktobe LLP
BIN: 210340011980

Registered address:
Republic of Kazakhstan, Aktobe, Astana District,
15 Akkagaz Doszhanova St.

IBAN: KZ356010121000324121
with Halyk Bank of Kazakhstan JSC
BIC: HSBKKZKX
KBe: 17 KNP: 862

Email: ecomed.aktobe@mail.ru
Telephone: 8 701 224 15 45
Website: www.ecomed.kz

Appendix 1

to the Public Offer Agreement
for the Provision of Medical Services

dated April 23, 2024

Rules of Conduct for Patients and Their Legal Representatives at the Clinic

1. To maintain order and ensure safety, audio and/or video surveillance is conducted in the Clinic’s halls.

1.1. All conversations with the Clinic’s call center operators are recorded.

2. Visits to the Clinic are subject to the following rules:

2.1. Upon entering the Clinic, visitors are advised to put on shoe covers or change into indoor footwear.

2.2. During the cold season, Patients must leave outerwear in the cloakroom. Entering a medical office while wearing outerwear is prohibited at any time of year.

2.3. A specific amount of appointment time is allocated to each Patient according to the schedule. Late arrival or delays may reduce the quality of the service provided and delay the next Patient’s appointment. If a Patient is late by more than 30% of the allocated appointment time, the physician reserves the right to reschedule the appointment if it cannot be extended without adversely affecting subsequent Patients.

2.4. The Patient may enter the physician’s office only upon invitation. Entering the physician’s office without invitation while an appointment is in progress is prohibited.

2.5. Accompanying persons (except the Patient’s legal representatives) may remain in the physician’s office only with the attending physician’s permission and provided that they comply with all of the physician’s requirements and instructions, except in cases provided for by applicable law.

2.6. All visitors (Patients, legal representatives, and accompanying persons) must observe the rules of personal hygiene.

2.7. The Patient has the right to obtain from the attending physician, anesthesiologist, reproductive medicine specialist, gynecologist, urologist-andrologist, etc., all information of interest regarding the proposed examination, treatment, and/or surgical intervention.

2.8. The Patient must immediately notify the attending physician of any deterioration in health. If the attending physician is unavailable, this information must be provided to an employee of the Clinic’s reception desk.

2.9. Cleanliness and order must be maintained on the Clinic premises. Waste and used personal hygiene products must be disposed of only in designated waste bins. Used shoe covers must be placed in the special bin located in the Clinic lobby.

2.10. During epidemics, visitors must observe social discipline and use personal protective equipment, including gauze or other masks intended to protect against respiratory infections.

2.11. During visits to the Clinic, Patients and accompanying persons must treat the Clinic’s property with care.

2.12. Clinic personnel have the right to refuse to provide services to a Patient who fails to comply with the stated rules of conduct and all terms of this Agreement.

2.13. The Clinic shall not be responsible for personal belongings, valuables, telephones, or money that have not been deposited for safekeeping.

2.14. If any property is damaged (destroyed, spoiled, damaged, etc.), the responsible person shall voluntarily compensate the medical center for the damage within 7 (seven) working days from the date a claim is submitted, or the Clinic administration has the right to recover such damages from the responsible person in accordance with the procedure established by law.

3. The following are strictly prohibited:
— using obscene language;
— behaving rudely toward Clinic personnel or other persons present at the Clinic, or engaging in disputes with them in the presence of others;
— shouting, speaking loudly, making excessive noise, or slamming doors;
— making video recordings in the healthcare organization during an epidemic, quarantine regime, or state of emergency;
— talking on the telephone during appointments or medical procedures;
— throwing litter or shoe covers on the floor or running through the Clinic;
— acting as a sales representative or engaging in the sale of any goods;
— consuming alcoholic beverages, smoking on the porch or anywhere inside the Clinic, or consuming other substances that alter consciousness or behavior.

The following shall be considered violations:
● rude or disrespectful behavior toward personnel, other Patients, or other persons;
● violation of the rights and legitimate interests of other Patients;
● failure to attend or late arrival for a physician’s appointment or procedure;
● failure to comply with the physician’s recommendations;
● failure to comply with the requirements of medical personnel while they perform various procedures;
● taking medicinal products at one’s own discretion;
● smoking inside the Clinic or on Clinic premises (Prohibited!);
● violation of the internal regulations and rules of conduct set forth in the Agreement;
● being on Clinic premises while under the influence of alcohol or narcotic substances.

Clinic personnel have the right to refuse to provide medical care to a Patient who fails to comply with the stated rules of conduct and all terms of this Agreement.

In the event of unlawful or inappropriate behavior by the Patient, abusive statements toward another Patient or medical personnel, the Patient being under the influence of alcohol or narcotic substances, or violation of these rules, the Clinic administration reserves the right to refuse further observation and treatment of the Patient, provided that doing so does not threaten the Patient’s life (except in emergency cases), and to discharge the Patient with an appropriate notation in the certificate of temporary incapacity for work and medical record regarding violation of the prescribed regimen and rules of conduct.

The Clinic administration shall not be responsible for valuables that have not been deposited for safekeeping.

Appendix 2

to the Public Offer Agreement
for the Provision of Medical Services

dated April 23, 2024

Feedback

We are very grateful to our Consumers/Clients for their feedback on our work and for suggestions on how to improve the quality of service at the Clinic.

Each request is reviewed individually by the Clinic’s management, with a mandatory response provided within 30 (thirty) working days.

You can leave feedback about the work of the Clinic’s team of specialists or share your wishes and suggestions in any convenient way:

* on the Clinic’s website (the “Reviews” section); 2GIS, etc.

At the Clinic:

* — in the feedback and suggestions book available at the reception desk;
* by email (info@ecomed.kz with the subject “Feedback and Suggestions”).

The Center’s social media pages:
• Instagram KZ – https://www.instagram.com/ecomed.kz
• Instagram Aktobe — https://www.instagram.com/ecomedaktobe/
• Facebook — https://www.facebook.com/ecomed aktobe

For any questions or suggestions, the Patient may also contact the Internal Audit and Patient Support Service and/or the head of the Clinic, as well as the heads of the relevant structural departments responsible for medical services and reception:

* Director: Almas Kadrzhanovich Urkimbayev;
* Deputy Director for Medical Affairs: Bekzat Kurmanbayevna Dzhakupova, by prior appointment;

• Head of the Internal Audit and Patient Support Service: Sairan Bakhatkhany

Ecomed-Aktobe LLP
BIN: 210340011980

Registered address:
Republic of Kazakhstan, Aktobe, Astana District,
15 Akkagaz Doszhanova St.

IBAN: KZ356010121000324121
with Halyk Bank of Kazakhstan JSC
BIC: HSBKKZKX
KBe: 17 KNP: 862

Email: ecomed.aktobe@mail.ru
Telephone: 8 701 224 15 45
Website: www.ecomed.kz