Consent to collect and use data

I, [your name], allow [app/assistant name] to collect, store, and use my personal health details so they can give me customized medical help on their chat assistant/app.

The health details could include:

My symptoms
My Medical history
My Medications
My physical activity
Test results
Other information share on the assistant/app

I know these health details are sensitive personal information under India’s new data protection law.

If I change my mind, I can take back this allowance later by following [app/assistant name’s] withdrawal process.

I am okay with [app/assistant name] collecting and using them on their chat assistant app. [app/assistant name] explained this in their privacy policy from [date]. This allowance lasts for [number] year(s) from when I sign.

I can also check my health details that [app/assistant name] has, fix them if they’re wrong, and ask [app/assistant name] to delete them when they’re not needed anymore. [app/assistant name] will keep my health details safe.

They won’t let others see or use them without permission, and they’ll protect them from being lost or destroyed.

If I have any problems, I can complain to the Data Protection Board of India.

By signing, I agree [app/assistant name] can collect and use my health details. I read their privacy policy.

Consent to collect and use data

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