{"id":4352,"date":"2024-08-08T14:33:13","date_gmt":"2024-08-08T18:33:13","guid":{"rendered":"https:\/\/www.chirurgivision.com\/?page_id=4352"},"modified":"2024-08-08T14:33:27","modified_gmt":"2024-08-08T18:33:27","slug":"forms","status":"publish","type":"page","link":"https:\/\/www.chirurgivision.com\/en\/patient-section\/forms\/","title":{"rendered":"Forms"},"content":{"rendered":"\n[et_pb_section fb_built=\u00a0\u00bb1″ module_class=\u00a0\u00bbdefaut-titre-section layout2″ _builder_version=\u00a0\u00bb4.21.0″ _module_preset=\u00a0\u00bbdefault\u00a0\u00bb locked=\u00a0\u00bboff\u00a0\u00bb global_colors_info=\u00a0\u00bb{}\u00a0\u00bb][et_pb_row _builder_version=\u00a0\u00bb4.21.0″ _module_preset=\u00a0\u00bbdefault\u00a0\u00bb global_colors_info=\u00a0\u00bb{}\u00a0\u00bb][et_pb_column type=\u00a0\u00bb4_4″ _builder_version=\u00a0\u00bb4.21.0″ _module_preset=\u00a0\u00bbdefault\u00a0\u00bb global_colors_info=\u00a0\u00bb{}\u00a0\u00bb][et_pb_post_title meta=\u00a0\u00bboff\u00a0\u00bb featured_image=\u00a0\u00bboff\u00a0\u00bb _builder_version=\u00a0\u00bb4.21.0″ _module_preset=\u00a0\u00bbdefault\u00a0\u00bb locked=\u00a0\u00bboff\u00a0\u00bb global_colors_info=\u00a0\u00bb{}\u00a0\u00bb][\/et_pb_post_title][\/et_pb_column][\/et_pb_row][et_pb_row module_class=\u00a0\u00bbprivate-row\u00a0\u00bb _builder_version=\u00a0\u00bb4.21.0″ _module_preset=\u00a0\u00bbdefault\u00a0\u00bb global_colors_info=\u00a0\u00bb{}\u00a0\u00bb][et_pb_column type=\u00a0\u00bb4_4″ _builder_version=\u00a0\u00bb4.21.0″ _module_preset=\u00a0\u00bbdefault\u00a0\u00bb global_colors_info=\u00a0\u00bb{}\u00a0\u00bb][et_pb_text _builder_version=\u00a0\u00bb4.21.0″ _module_preset=\u00a0\u00bbdefault\u00a0\u00bb global_colors_info=\u00a0\u00bb{}\u00a0\u00bb]

Questionnaire pr\u00e9op\u00e9ratoire<\/h3>[\/et_pb_text][et_pb_button button_url=\u00a0\u00bbhttps:\/\/www.chirurgivision.com\/wp-content\/uploads\/2023\/12\/ChirurgiVision-Questionnaire-Preoperatoire.pdf\u00a0\u00bb url_new_window=\u00a0\u00bbon\u00a0\u00bb button_text=\u00a0\u00bbT\u00e9l\u00e9charger\u00a0\u00bb _builder_version=\u00a0\u00bb4.23.1″ _module_preset=\u00a0\u00bbdefault\u00a0\u00bb global_colors_info=\u00a0\u00bb{}\u00a0\u00bb][\/et_pb_button][et_pb_divider divider_weight=\u00a0\u00bb2px\u00a0\u00bb _builder_version=\u00a0\u00bb4.21.0″ _module_preset=\u00a0\u00bbdefault\u00a0\u00bb global_colors_info=\u00a0\u00bb{}\u00a0\u00bb][\/et_pb_divider][et_pb_text _builder_version=\u00a0\u00bb4.21.0″ _module_preset=\u00a0\u00bbdefault\u00a0\u00bb global_colors_info=\u00a0\u00bb{}\u00a0\u00bb]

Questionnaire s\u00e9cheresse oculaire<\/h3>[\/et_pb_text][et_pb_button button_url=\u00a0\u00bbhttps:\/\/www.chirurgivision.com\/wp-content\/uploads\/2024\/01\/ChirurgiVision-Questionnaire-Secheresse-oculaire.pdf\u00a0\u00bb url_new_window=\u00a0\u00bbon\u00a0\u00bb button_text=\u00a0\u00bbT\u00e9l\u00e9charger\u00a0\u00bb _builder_version=\u00a0\u00bb4.23.1″ _module_preset=\u00a0\u00bbdefault\u00a0\u00bb global_colors_info=\u00a0\u00bb{}\u00a0\u00bb][\/et_pb_button][et_pb_divider divider_weight=\u00a0\u00bb2px\u00a0\u00bb _builder_version=\u00a0\u00bb4.21.0″ _module_preset=\u00a0\u00bbdefault\u00a0\u00bb global_colors_info=\u00a0\u00bb{}\u00a0\u00bb][\/et_pb_divider][et_pb_text _builder_version=\u00a0\u00bb4.21.0″ _module_preset=\u00a0\u00bbdefault\u00a0\u00bb global_colors_info=\u00a0\u00bb{}\u00a0\u00bb]

Obtenir une copie de mon dossier m\u00e9dical<\/h3>[\/et_pb_text][et_pb_accordion _builder_version=\u00a0\u00bb4.24.2″ _module_preset=\u00a0\u00bbdefault\u00a0\u00bb hover_enabled=\u00a0\u00bb0″ border_width_all=\u00a0\u00bb2px\u00a0\u00bb border_color_all=\u00a0\u00bb#000000″ global_colors_info=\u00a0\u00bb{}\u00a0\u00bb sticky_enabled=\u00a0\u00bb0″][et_pb_accordion_item title=\u00a0\u00bbModalit\u00e9s d’acc\u00e8s\u00a0\u00bb open=\u00a0\u00bbon\u00a0\u00bb _builder_version=\u00a0\u00bb4.24.2″ _module_preset=\u00a0\u00bbdefault\u00a0\u00bb background_color=\u00a0\u00bbRGBA(255,255,255,0)\u00a0\u00bb background_enable_color=\u00a0\u00bbon\u00a0\u00bb global_colors_info=\u00a0\u00bb{}\u00a0\u00bb]

Toute demande de communiquer des renseignements contenus au dossier d’un patient doit \u00eatre transmise \u00e0 la personne responsable des archives et doit \u00eatre approuv\u00e9e par le directeur m\u00e9dical.<\/span><\/strong><\/p>\n

1.1 Consentement \u00e9crit<\/strong><\/p>\n

Une autorisation \u00e9crite est exig\u00e9e pour la divulgation des informations contenues au dossier. La signature du patient ou de la personne pouvant donner un consentement en son nom et la date du consentement sont essentielles sur tout consentement \u00e9crit ainsi qu’une preuve d’identit\u00e9. Si la demande est effectu\u00e9e par courriel, une copie du permis de conduire est exig\u00e9e pour valider l’identit\u00e9 du demandeur.<\/p>\n

1.2 D\u00e9lai<\/strong><\/p>\n

La Clinique ChirurgiVision doit donner au patient la copie de son dossier dans les plus brefs d\u00e9lais. La loi pr\u00e9voit un d\u00e9lai de 30 jours<\/strong> qui suivent la date de r\u00e9ception de la demande.<\/p>\n

Il doit \u00e9galement, sur demande de celui-ci, faire parvenir dans les plus brefs d\u00e9lais \u00e0 un autre \u00e9tablissement ou \u00e0 un professionnel, une copie, un extrait, un r\u00e9sum\u00e9 de son dossier.<\/p>\n

1.3 Tarification<\/strong><\/p>\n

Des frais sont exigibles pour la transcription, la reproduction et la transmission des documents concernant un patient. La tarification est affich\u00e9e sur la liste de prix en vigueur. Une copie de dossier transmise \u00e0 un professionnel de la sant\u00e9 est sans frais.<\/p>\n

La copie de dossier m\u00e9dical sera transmise par la poste, par courriel ou par t\u00e9l\u00e9copieur.<\/strong><\/p>\n

Sources : Politiques d’acc\u00e8s \u00e0 l’information et r\u00e8gles de confidentialit\u00e9. Normes 26.3, 26.4 et 26.5.<\/em><\/p>[\/et_pb_accordion_item][\/et_pb_accordion][et_pb_button button_url=\u00a0\u00bbhttps:\/\/www.chirurgivision.com\/wp-content\/uploads\/2023\/12\/ChirurgiVision-Autorisation.pdf\u00a0\u00bb url_new_window=\u00a0\u00bbon\u00a0\u00bb button_text=\u00a0\u00bbT\u00e9l\u00e9charger\u00a0\u00bb _builder_version=\u00a0\u00bb4.23.1″ _module_preset=\u00a0\u00bbdefault\u00a0\u00bb global_colors_info=\u00a0\u00bb{}\u00a0\u00bb][\/et_pb_button][et_pb_divider divider_weight=\u00a0\u00bb2px\u00a0\u00bb _builder_version=\u00a0\u00bb4.21.0″ _module_preset=\u00a0\u00bbdefault\u00a0\u00bb global_colors_info=\u00a0\u00bb{}\u00a0\u00bb][\/et_pb_divider][et_pb_text _builder_version=\u00a0\u00bb4.21.0″ _module_preset=\u00a0\u00bbdefault\u00a0\u00bb global_colors_info=\u00a0\u00bb{}\u00a0\u00bb]

Formulaire de plainte, commentaires ou suggestions<\/h3>[\/et_pb_text][et_pb_button button_url=\u00a0\u00bbhttps:\/\/www.chirurgivision.com\/wp-content\/uploads\/2023\/12\/ChirurgiVision-Autorisation-Plaintes-commentaires-suggestions.pdf\u00a0\u00bb url_new_window=\u00a0\u00bbon\u00a0\u00bb button_text=\u00a0\u00bbT\u00e9l\u00e9charger\u00a0\u00bb _builder_version=\u00a0\u00bb4.23.1″ _module_preset=\u00a0\u00bbdefault\u00a0\u00bb global_colors_info=\u00a0\u00bb{}\u00a0\u00bb][\/et_pb_button][\/et_pb_column][\/et_pb_row][\/et_pb_section]\n","protected":false},"excerpt":{"rendered":"

Questionnaire pr\u00e9op\u00e9ratoireQuestionnaire s\u00e9cheresse oculaireObtenir une copie de mon dossier m\u00e9dicalToute demande de communiquer des renseignements contenus au dossier d’un patient doit \u00eatre transmise \u00e0 la personne responsable des archives et doit \u00eatre approuv\u00e9e par le directeur m\u00e9dical. 1.1 Consentement \u00e9crit Une autorisation \u00e9crite est exig\u00e9e pour la divulgation des informations contenues au dossier. La signature […]<\/p>\n","protected":false},"author":5,"featured_media":0,"parent":4331,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_acf_changed":false,"_et_pb_use_builder":"on","_et_pb_old_content":"","_et_gb_content_width":"","protect_children":false,"footnotes":""},"class_list":["post-4352","page","type-page","status-publish","hentry"],"acf":[],"yoast_head":"\nForms | ChirurgiVision<\/title>\n<meta name=\"description\" content=\"T\u00e9l\u00e9chargez nos formulaires : questionnaire pr\u00e9op\u00e9ratoire, s\u00e9cheresse oculaire, dossier m\u00e9dical, plaintes et commentaires.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.chirurgivision.com\/en\/patient-section\/forms\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" 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