Declaration of Consent

I hereby declare my agreement with the following:

My patient dossier (and other data concerning me) will be kept by Holistiq Health Group AG (“Holistiq Health”) and may be accessed by the therapists (including their assistants) of Holistiq Health. Additionally, to the extent necessary for the purposes of my treatment, counseling, or care, I hereby authorize the therapists of Holistiq Health to obtain medical records and information concerning me from external healthcare professionals and medical institutions (e.g. hospitals. medical practices) and release the involved healthcare professionals from their legal obligation of confidentiality in this regard.

The transmission of data necessary for invoicing to billing institutions, the delivery of invoice copies to me, and communication between me and Holistiq Health (including their therapists) may occur electronically. Billing and collection may be outsourced to third parties, who may disclose my data (also electronically) in this context, as well as to relevant authorities (e.g. debt collection offices), courts, and other involved parties (e.g. insurance companies and attorneys).

I am aware that despite the implementation of technical and organizational measures, electronic data exchange entails risks for data security, particularly concerning the confidentiality of my data. I accept these risks associated with electronic data transmission and communication.

Information regarding the processing of your personal data by Holistiq Health can be found in our most current privacy policy. You can access this online at

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