Public offer

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Public Offer Agreement
for the Provision of Medical Services

Republic of Kazakhstan, Kyzylorda January 03, 2022

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-Syrdariya LLP, in accordance with Articles 387 and 395 of the Civil Code of the Republic of Kazakhstan.

1.2. Acceptance of the 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-Syrdariya LLP.

1.4. Ecomed-Syrdariya LLP, hereinafter referred to as the “Clinic and/or Provider,” represented by the 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 and conditions of this Agreement are the same for all Patients/Customers.

1.8. Evidence of full and unconditional acceptance of the terms and conditions of this Agreement, as well as the date on which the Agreement is concluded, 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 one of the following actions:
— making a preliminary 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 to enter 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 applicable state licenses for medical activities and the current regulatory legal acts governing healthcare in the Republic of Kazakhstan, while 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 07, 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 Reproductive Organ Tissues”;
— 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 04, 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 Protection of Consumer Rights” 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 Repeal of Certain Decisions of the Government of the Republic of Kazakhstan”;
— 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 the Agreement for the Provision of Paid Medical Services (Care).”

3.2. Place of provision of medical services: Kyzylorda, Arai microdistrict, 91 M. Azhikozha St.

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 both during and after the provision of services, in the immediate or long-term period. The Patient also agrees that the medical technologies used cannot completely eliminate the possibility of side effects and complications arising from the biological characteristics of the body.

3.4. The Clinic/Provider provides services under this Agreement during its working days and hours. Appointments may be scheduled daily during the Clinic’s working hours for any available time and 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 working hours, online appointment requests are accepted only through the website.

Such information is processed during the first working hours of the call center operators.

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

3.5. All specialist consultations are provided by appointment:
— through the Clinic’s website at 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 specialty and the type of appointment (initial/follow-up consultation, consultation/examination, or other services).

► An initial consultation may last from 30 (thirty) to 40 (forty) minutes. Within this range, the duration of each consultation is determined by the specialist.
► A follow-up consultation with a specialist 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 urgent medical care must be provided to another patient in serious condition, or another patient requires an emergency 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. Appointment booking 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 working hours, a technical failure may have occurred, in which case the request should be resubmitted or the call center should be contacted by telephone.

More detailed information can be obtained from the call center or at the reception desk.

3.9. If a patient with an infectious disease seeks care at 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. In order 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 Equipment, and Photo and Video Equipment Used in Medical Organizations to Protect the Rights of Patients and Medical Workers, as approved by the authorized body.

3.11. The Patient must have 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 settlement 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 at the earliest opportunity.

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 a prior appointment has been made 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, if necessary to attend to a patient in a more serious condition or to reduce other patients’ contact with a patient suffering from an infectious disease transmitted through the respiratory route. 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 obligated to provide a replacement physician.

3.16. If the Patient/Customer arrives 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 the service entirely, without refunding or recalculating the amount paid for it.

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

3.18. If Patients seek medical care at the Clinic and there are sufficient grounds to believe that harm to their health resulted from 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 the preparation of medical records. Pursuant to 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 Healthcare Records,” the Patient must provide personal data, including full name, IIN, age, residential address, and contact telephone number, both when visiting the Clinic and when making an appointment.

3.20. 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. A specific appointment time is allocated to each Patient. Late arrival and delays may reduce the quality of the service provided and delay the appointment of the next Patient.

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

3.22. The Patient shall enter the office of a physician or other Clinic staff member only upon invitation. Entering a staff member’s office without invitation while another consultation is in progress is prohibited. This shall be regarded as a violation of the Clinic’s internal regulations and as disrespectful behavior toward both Clinic staff and other patients.

3.23. The Patient has been informed that failure to follow 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 timeframe, or adversely affect the Patient’s health.

3.24. If the Patient violates the Clinic’s internal regulations or rules of conduct, interferes with the lawful activities of medical workers, shows disrespect toward Clinic staff, including making negative statements about the Clinic’s physicians or personnel, behaves rudely toward staff, fails to comply with medical instructions, recommendations, or prescriptions, or in the event of psychological incompatibility resulting in a medical conflict between the Patient and physician, the Clinic has the right to terminate this Agreement from the moment such violations are identified, provided that termination of medical services does not endanger 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 personal hygiene rules.

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

3.27. Before each invasive intervention, the Patient shall sign an informed consent form after first 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 shall be the property of the Clinic if provided to the Patient by the Clinic’s medical personnel during their working hours. The Patient has the right to provide such medical reports to medical professionals at other healthcare 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, and online communication services, or showing them to third parties without the Clinic’s consent, unless otherwise provided by the legislation of the Republic of Kazakhstan.

3.29. Clinic staff have the right to refuse service to a 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 presented, or the administration shall have the right to recover the amount 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 and after medical services, both in the immediate and long-term period. The Patient also agrees that the medical technologies used cannot completely eliminate the possibility of side effects and complications arising from the biological characteristics of the 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 actions of the attending physician or perform other actions that disrupt the process of providing medical care;
— show disrespect toward other patients or Clinic employees;
— damage Clinic property;
— disturb the peace and order within the Clinic, make excessive noise, slam doors, etc.;
— speak on a mobile phone during consultations or medical procedures;
— use obscene language, swear at or behave rudely toward Clinic staff or other persons present at the Clinic, or engage in confrontations 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 staff or other Patients.

3.33. While on the premises of the Clinic and the adjacent territory, the Patient, their legal representative, and accompanying persons are strictly prohibited from:
— consuming alcoholic beverages or other narcotic or intoxicating substances, or smoking on the porch or in any premises of 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 inappropriate, unacceptable, or aggressive behavior by the Patient, their legal representatives, or accompanying persons, including violent or disorderly conduct, rude statements directed at 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 waste bins, while used shoe covers must be placed in the designated bin located in the Clinic lobby.

3.36. During an epidemiological situation, the Patient, their 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, or medical services to a Patient who fails to comply with the above internal regulations and rules of conduct.

4. PAYMENT PROCEDURE

4.1. Services shall be paid for in full at the cashier’s office on the day the service is provided, before the initial/follow-up consultation with a 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’s Patient to the same medical specialist during the same month.

4.2. The cost of paid medical services provided to the Patient/Customer shall be determined in accordance with the Price List for Paid Medical Services approved by the Clinic/Provider and in effect at the time the Patient seeks services.

4.3. Payment for medical services shall be made by the Patient/Customer personally (or, with their consent, by another person) in full on the day the services commence, in accordance with the applicable Price List.

4.4. In the event of a justified refusal by the Patient/Customer to undergo 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 concluded between the Clinic and the Patient.

4.5. In the event of early termination of a service, the Clinic/Provider shall refund to the Patient/Customer the difference between the amount paid and the cost of the 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 have been 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, procedures for the provision of medical care, and applicable standards of medical care;

5.1.2. Comply with regulatory legal acts in the field of healthcare;

5.1.3. Provide the Patient/Customer with an opportunity to review the Price List applicable 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 the provision of medical care free of charge if, during the provision of paid medical services, additional emergency medical services become necessary to eliminate a threat to the Patient’s life arising from sudden acute diseases, conditions, or exacerbations of 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 with free, accessible, and reliable information, including information about the location of the Clinic (place of its state registration), operating hours, the list of medical services provided, and the 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 is required;
— of contraindications and possible adverse consequences associated with a specific 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. Provide the Patient with direct access to medical documentation reflecting their state of health and, upon the written request of the Patient or their legal representative, issue copies of medical documents reflecting the Patient’s state of health;

5.1.10. Issue medical documentation to the Patient, as well as medical reports concerning their state of health specifying examinations performed and treatment measures undertaken, 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 while providing medical services;

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

5.1.13. Treat the Patient/Customer respectfully and humanely;

5.1.14. Provide high-quality medical services using modern diagnostic and treatment methods, in full accordance with this Agreement, after the Patient/Customer has made payment 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 funds 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 necessary for diagnosis and treatment, guided by clinical diagnostic and treatment protocols, procedures and standards for the provision of medical care approved by the Ministry of Healthcare of the Republic of Kazakhstan, or, in the absence of relevant clinical protocols, by the professional experience of its physicians, generally accepted approaches, evidence-based medicine, 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 the Patient/Customer fails to comply with medical prescriptions, 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 their payment obligations for medical services;

5.2.5. Refuse to provide services:
— if contraindications to diagnostic or therapeutic 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 specific types of services (voluntary informed consent to medical intervention, etc.);
— if the Patient violates the Clinic’s internal regulations or rules of conduct set forth in this Agreement;
— if it is impossible to ensure the safe provision of a medical service.

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

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

5.2.8. If the Patient arrives more than 15 (fifteen) minutes after the scheduled time for receiving the service, 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 stipulated 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-Syrdariya LLP.

6.1.2. Timely and accurately comply with medical prescriptions, instructions, and recommendations of the attending physician and relevant specialists providing medical services in relation to treatment and examinations; comply with the internal regulations of the Clinic/Provider, the therapeutic and protective regimen, occupational safety requirements, 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 and from following recommendations or receiving treatment from healers, practitioners of alternative medicine, or physicians from other healthcare organizations without first coordinating such actions with the attending physician;

6.1.5. Treat medical workers and other persons involved in providing 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 for 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 delivering medical care with the complete and accurate information necessary to ensure the proper provision of medical services, including personal data; information about their own health and the health of close relatives; information about any history of pathology, hereditary, previous, or current diseases, infections, surgical procedures, possible contraindications, including contraindications to medications, individual characteristics of the body, harmful habits, occupational hazards, allergic reactions, and any other necessary documents. The Patient shall also provide the results of previous examinations and specialist consultations performed outside the Clinic/Provider, if available, and all other known information concerning their health and other factors that may affect the course of treatment.

6.1.9. The Patient must understand that knowingly providing inaccurate information concerning their health may affect the accuracy of the diagnosis, the treatment prescribed, and the prognosis for recovery.

6.1.10. The Patient must immediately notify the attending physician of any deterioration in their health and, during a course of treatment, inform the attending physician of any changes in well-being and immediately report any adverse situations that could cause harm to their health;

6.1.11. In the absence of the attending physician, provide such information to a member of the Clinic’s reception desk or call center staff.

6.1.12. Provide contact information (email address, telephone numbers, actual residential address), as well as 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 threat to the Patient’s/Customer’s health, provide an appropriate 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 after the scheduled service time, the Clinic/Provider reserves the right to reschedule or cancel the service.

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

6.1.16. During epidemics and 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. The Patient must 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.

6.2.4. Request from the Clinic/Provider necessary medical information and supporting documents concerning their state of health.

6.2.5. Request additional explanations from the Clinic/Provider regarding their health condition and the proposed methods of diagnosis and treatment if the explanations previously provided were not understood.

6.2.6. 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;

6.2.7. Examination and treatment under conditions that comply with sanitary, hygienic, and anti-epidemic requirements;

6.2.8. Voluntary informed consent to medical intervention in accordance with applicable legislation;

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

6.2.10. Contact the Internal Audit and Patient Support Service, Clinic officials, regulatory and/or supervisory authorities, or the courts;

6.2.11. Non-disclosure by 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.

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

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

7. CONFIDENTIALITY

7.1. For the purposes 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, and, where necessary, documents confirming marital status and other information) and consents to the processing by Clinic personnel of their personal data, as well as special personal data concerning 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 necessary to achieve the above purposes, including, without limitation: collection, systematization, accumulation, storage, clarification (updating or modification), use, distribution (including transfer), anonymization, blocking, destruction, and any other actions involving personal data permitted by applicable legislation. The Patient also consents to photo, video, and audio recording at the Clinic. Personal data shall be processed by the Clinic using the following methods: automated processing of personal data and processing of personal data without the use of automation tools (non-automated processing).

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

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

7.5. The Parties undertake not to disclose to third parties not involved in providing the Services, or use for purposes other than the proper performance of obligations under the Agreement, any information received from the other Party in accordance with 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 prior to receiving it under the Agreement.

7.6. Information deemed confidential under this Agreement may be transferred to third parties or otherwise disclosed outside the Clinic only after obtaining the written consent of the other Party, except where such consent is not required by law.

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

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

7.9. Medical examination results 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 and using the contact details specified by the Patient during registration.

7.10. The Patient/Customer provides consent to the processing of personal data and informed consent to the provision of services at the Clinic reception desk by signing on an automated device using a digital signature key or by another method that does not contradict applicable legislation.

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

7.10.2. By signing this Agreement, the Patient/Customer consents to audio recording, photography, and video recording on the premises of the Clinic/Provider, as well as to the publication of audio, photographic, and video materials on the official website of the Clinic/Provider.

7.10.3. I have read and accept the terms and conditions 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 at 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 or 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, fraudulent, incorrect, etc.

8.4. The Clinic/Provider shall not be liable for the quality of medical services where the Patient/Customer has provided incomplete information about 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’s/Customer’s health or for failure to recover if such circumstances resulted from the Patient’s/Customer’s failure to comply with medical instructions.

8.6. If the Patient/Customer fails to comply with the recommendations and requirements of the Clinic’s medical personnel 2 (two) or more times, 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 has the right to send the other Party a written statement of its claims. The Party receiving the claim shall respond to it 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 performance of other actions aimed at worsening the Patient’s 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 medications or medical devices approved for use;
— medical intervention by third parties after the Clinic’s services have been provided;
— the Patient’s informed refusal to continue treatment where the Patient was warned that the medical services actually provided in such circumstances might be ineffective;
— the Patient’s subsequent health condition or complications associated with refusal of treatment in general or individual medical interventions;
— occurrence of side effects from medicines and pharmaceutical products where the possibility of such side effects was indicated by the manufacturer in the relevant instructions;
— failure by the Patient to fulfill the obligation to inform the physician of previous diseases, allergic reactions, or contraindications where the ineffectiveness of the medical service or harm caused resulted from the physician not having 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 control (natural disasters, epidemics, military actions, strikes, adoption of relevant decisions by competent authorities, etc.) that prevent performance of obligations under this Agreement.

8.11. The Patient/Customer shall be liable for obstructing the lawful activities of medical and/or pharmaceutical workers, violating quarantine requirements, sanitary rules and hygiene standards, and committing administrative offenses infringing public order and morality, for which penalties and liability are prescribed in the Republic of Kazakhstan. The Patient/Customer shall also be liable 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 payment terms for medical services, the Clinic/Provider may apply contractual penalty measures. If the Patient has outstanding debts for services provided by the Clinic, the Clinic has the right to suspend further provision of services under this Agreement until the Patient has fully paid for the services already provided.

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

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

9. AMENDMENT OF THE TERMS 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 upon their public publication. 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 shall enter into force on the date of its public publication and shall remain valid until January 03, 2027, and in particular until the Parties have fully performed their obligations or the Agreement has been terminated. Under the terms of the Agreement, if its provisions are violated, the Clinic has the right to terminate the Agreement unilaterally by sending written notice to the other Party. Accordingly, termination of the Agreement does not require the mandatory signing of a 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. In the event of a violation of the Patient’s rights, the Patient (or their legal representative) may submit a written complaint through the reception desk, which shall be forwarded to the head of the Clinic for consideration. The complaint may be entered in the Book of Reviews and Suggestions or submitted electronically through the Clinic’s website. To receive a prompt response to a complaint, the Patient is advised to provide a contact telephone number to the Internal Audit and Patient Support Service. The complaint shall be reviewed in accordance with the procedure established by law.

11.3. A complaint 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 orally. A response to a complaint submitted through the Clinic’s website shall be sent electronically to the email address provided by the Patient.

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

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-funded healthcare order, shall be determined independently by the Clinic and specified in the Clinic’s service price list approved by order of the Clinic Director. Information concerning the prices of the Clinic’s 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 promotions announced on its website, through its 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 application accompanied by official supporting documents, which shall be reviewed 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 as a result of extraordinary circumstances that the Party could neither foresee nor prevent.

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

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

13.4. The Parties shall not be liable for failure to perform the terms of the Agreement where 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 the delay in performance of the Agreement results from force majeure circumstances.

13.6. If force majeure circumstances arise, the Clinic/Provider shall immediately send the Patient/Customer written notice of such circumstances and their causes. Unless the Patient/Customer provides other written instructions, the Clinic/Provider shall continue to perform 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 concerning their health condition, including information on examination results, the presence of a disease, its diagnosis and prognosis, treatment methods and associated risks, possible options for medical intervention and their consequences, and the results of treatment.

14.2. Information concerning 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 authorized Clinic officials. Such information shall include examination results, the presence of a disease, diagnosis and prognosis, methods of examination and treatment and their associated risks, possible options for medical intervention and their consequences, as well as treatment results and possible complications. Information concerning a person’s health condition may not be provided to that person against their will. In cases involving an unfavorable prognosis, the information shall be communicated sensitively to the citizen and members of their family unless the citizen has prohibited such disclosure and/or designated another person to whom the information should be communicated.

14.3. For minors under the age of 18 and persons declared legally incapacitated in accordance with the procedure established by law, information concerning 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 their legal representatives only on grounds provided for by applicable legislation.

15. PROCEDURE FOR ISSUING TEMPORARY DISABILITY CERTIFICATES, MEDICAL CERTIFICATES, AND EXTRACTS FROM THE PATIENT’S 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 legislation.

15.2. A document certifying the Patient’s temporary incapacity for work is a temporary disability certificate in the prescribed form, the issuance procedure for which is approved by Order No. ҚР ДСМ-198/2020 of the Minister of Healthcare of the Republic of Kazakhstan dated November 18, 2020 “On Approval of the Rules for Conducting an Assessment of Temporary Incapacity for Work and Issuing a Temporary Disability Certificate or Medical Certificate.”

15.3. When an embryo transfer is performed, the temporary disability certificate and medical certificate shall be issued by the medical organization that performed the procedure.

15.4. At the Patient’s request, a medical certificate concerning illness 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.

15. FINAL PROVISIONS

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

15.2. This Agreement is concluded through the Patient’s/Customer’s acceptance of the Clinic’s/Provider’s public offer and shall remain in effect 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 the amendments or withdrawal of the offer enter into effect.

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

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

15.5. 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/or made available in hard copy at the location of the Clinic/Provider. Amendments shall enter into force from the moment they are publicly published.

15.6. In all matters not provided for by this Agreement, the Parties shall be governed by the applicable legislation of the Republic of Kazakhstan.

16. DETAILS AND SIGNATURES OF THE PARTIES

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

16.2. Clinic/Provider:

Appendix 1
to the Public Offer Agreement
for the Provision of Medical Services
dated January 03, 2022

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, the Patient must leave outerwear in the cloakroom. Entry into a medical consultation room while wearing outerwear is prohibited at any time of year.

2.3. A specific appointment time is allocated to each Patient. Late arrival and 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 scheduled appointment duration, the physician reserves the right to reschedule the appointment if it cannot be extended without adversely affecting subsequent Patients.

2.4. The Patient shall enter the physician’s office only upon invitation. Entering the physician’s office without invitation while another consultation is in progress is prohibited.

2.5. Accompanying persons, other than the Patient’s legal representatives, may remain in the consultation room 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 legislation.

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

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 concerning the proposed examination, treatment, and/or surgical intervention.

2.8. The Patient must immediately notify the attending physician of any deterioration in their health condition. In the absence of the attending physician, such information must be provided to a member of the Clinic’s reception staff.

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

2.10. During epidemics, social discipline must be observed and personal protective equipment, including gauze or other masks intended to protect against respiratory infections, must be used.

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 service to a Patient who fails to comply with the rules of conduct set forth herein and all terms of this Agreement.

2.13. The Clinic shall not be liable 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 presented, or the Clinic administration shall have the right to recover compensation 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 staff or other persons present at the Clinic, or engaging in confrontations with them in the presence of others;
— shouting, speaking loudly, making excessive noise, or slamming doors;
— making video recordings during an epidemic, quarantine regime, or state of emergency introduced in the healthcare organization;
— speaking on the telephone during consultations and medical procedures;
— throwing litter or shoe covers on the floor or running around the Clinic;
— acting as a sales representative or engaging in commercial activities of any kind;
— consuming alcoholic beverages, smoking on the porch or in any premises of the Clinic, or consuming other substances that alter consciousness or behavior.

The following shall be considered violations:
● rude or disrespectful behavior toward staff, 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 are performing various procedures;
● taking medications at one’s own discretion;
● smoking inside the Clinic or on its premises (Prohibited!);
● violation of the internal regulations and rules of conduct set forth in the Agreement;
● being on the 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 rules of conduct set forth herein and all terms of this Agreement.

In the event of unlawful or inappropriate behavior by the Patient, rude statements directed at another Patient or medical personnel, the Patient being under the influence of alcohol or narcotic substances, or violation of the requirements of these Rules, the Clinic administration reserves the right to refuse further observation and treatment of the Patient, provided that this does not endanger the Patient’s life (except in emergency cases), and to discharge the Patient with an appropriate notation in the temporary disability certificate and medical history concerning violation of the prescribed regimen and the Patient’s rules of conduct.

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

Appendix 2
to the Public Offer Agreement
for the Provision of Medical Services
dated January 03, 2022

Feedback

We are very grateful to our Consumers/Clients for their feedback on our work and for submitting suggestions on how we can 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.

Feedback regarding the work of the Clinic’s team of specialists, as well as comments and suggestions, may be submitted in any convenient manner:
• through the Clinic’s website (the “Reviews” section), 2GIS, etc.

At the Clinic:
• through the Book of Reviews and Suggestions available at the reception desk;
• by email (info@ecomed.kz, marked “Reviews and Suggestions”).

Clinic social media pages:
• Instagram KZ – https://www.instagram.com/ecomed.kz
• Instagram ecomed_kyzylorda — https://www.instagram.com/ecomed_kyzylorda/

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 medical and reception departments, regarding any questions or suggestions:
• Director: Zhadyra Abduvaliyevna Zhandarbekova;
• Nurse: Gulzat Kosynbaykyzy Shatenova;
• Chief Accountant: Nurzhan Nugmanuly Nogayev;
• Medical Expert: Gulsim Kanatovna Abenova;
• Lawyer: Ainur Sattarbekovna Ospanova.

Ecomed-Syrdariya LLP
Republic of Kazakhstan, Kyzylorda, Arai microdistrict, 91 M. Azhikozha St.
BIN 180840026186
Settlement Account: KZ056010201000040835
BIC HSBKKZKX
Halyk Bank of Kazakhstan JSC
Director: Zhadyra Abduvaliyevna Dzhandarbekova
Email: ecomed17@mail.ru
Accounting Department: 8 701 604 63 41