The Ateneo de Manila University, through the Ateneo Molecular Pathology Laboratory (AMPLify), respects your privacy and aims to comply with all applicable privacy and data protection laws which includes but is not limited to the Data Privacy Act of 2012 (DPA), its implementing rules and regulations, other appropriate issuances of the National Privacy Commission, and the University's relevant data protection policies whenever we process your personal data in relation to our RT-PCR Testing Services.
Unless otherwise required or authorized by law, personal data will only be used for availing the SARS-CoV-2 diagnostic testing procedure. They will be stored and kept secure while the declared purpose of their collection subsists. Thereafter, they will be disposed of securely and permanently.
By availing of the testing services, I acknowledge the following:
Should you wish to exercise any of your rights or have any concern or question regarding them, this consent form, or any matter involving the University and data privacy, you may contact AMPLify at firstname.lastname@example.org. To the extent possible, the University Data Protection Office (UDPO) will also respond to your concerns at email@example.com (inquiries) or firstname.lastname@example.org (complaints/security incidents).
By agreeing to this, I hereby declare that:
I give my consent for the RT-PCR testing services.
Subgroup A: Patients or healthcare workers with severe/critical symptoms, relevant history of travel/contact
Subgroup B: Patients or healthcare workers with mild symptoms, relevant history pf travel/contact, and considered vulnerable. Vulnerable populations include those elderly and with preexisting medical conditions that predispose them to severe presentation and complications of COVID-19. These also include:
Subgroup C: Patients or healthcare workers with mild symptoms, relevant history of travel/contact
Subgroup D: Patients or healthcare workers with no symptoms but relevant history of travel/contact, with special attention to those living in confined spaces such as persons deprived of liberty or institutionalized persons
Subgroup E: Frontliners indirectly involved in health care provision in the response against COVID-19 which includes, but not limited to the following:
Subgroup F: Other vulnerable patients such as those with comorbidities like diabetes, heart diseases, etc., those will undergo high-risk elective surgical procedures, those who are pregnant, elderly, immunocompromised, and other.