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Legal

Patient Privacy Notice Template

In effect from
Version
1.0

The short version

  • This is a starting point for the notice your clinic shows patients. Your clinic is responsible for it, because your clinic decides what patient data to record and why.
  • Replace everything in [square brackets] with your clinic’s details, and remove anything that doesn’t apply to you.
  • Show the notice before you record a patient’s data, in English or any language listed in the Eighth Schedule of the Constitution that the patient prefers.
  • Record each acknowledgement in Substrate Console. It keeps which version of your notice each patient, or the person acting for them, acknowledged, and who recorded it.
  • This template is not legal advice. Have it reviewed for your clinic before you use it.

How to use this template

Everything below the line “Notice starts here” is written in your clinic’s voice, for your patients. Copy it into your clinic’s notice, fill in the details in [square brackets], and give it a version number and date. When you change it, raise the version so new acknowledgements are recorded against the right text.

Give the patient a copy they can keep, for example printed or on WhatsApp, and read it out or explain it if they need help. For a child, or someone who cannot consent for themselves, the notice goes to their parent or lawful guardian.

Notice starts here

[Clinic name], [address]

This notice explains what we record about you, why, and what you can ask us to do. Please read it before we register you. If anything is unclear, ask anyone at the front desk.

What we record

  • your name, sex, date of birth or age, phone number, address and an emergency contact
  • your ABHA number and ABHA address, if you choose to share them
  • your health records: consultation notes, prescriptions, allergies, lab results, and reports or scans you give us

We never record your Aadhaar number.

Why we record it

  • to treat you, and to see your history at future visits
  • to write and print your prescriptions and reports
  • to check new prescriptions against your recorded allergies and current medicines
  • to contact you about your care, such as appointments and results
  • to keep the records that medical and clinic regulations require

We do not use your records for advertising and we do not sell them.

Who can see it

Only people at [clinic name] who need it for your care or for running the clinic. Our records software records who opens or changes your record and when.

We keep your records in Substrate Console, record-keeping software provided by Substrate Labs. Substrate stores them for us, on our instructions only, with Cloudflare in Singapore. Substrate does not use them for anything else.

We share your records outside the clinic only when you ask us to, when another doctor needs them for your care and you agree, or when the law requires it. [If your clinic links records with ABDM: When you agree through the ABHA app, we may share records through the Ayushman Bharat Digital Mission.]

How long we keep it

We keep your records for [period] after your last visit, because medical regulations require doctors to keep them. After that we delete them, unless the law requires us to keep them longer.

What you can ask us

  • for a copy of, or a summary of, what we hold about you
  • to correct something that is wrong or incomplete. Signed notes are not rewritten; the correction is added and the original is kept.
  • to delete your records, unless the law requires us to keep them. If so, we explain why.
  • to stop using your data for anything you consented to, such as reminders
  • to name someone to act for you if you die or cannot act for yourself

Ask at the front desk, or write to [name or role] at [email] or [phone]. We reply within [30] days.

If you are not satisfied with our answer, you can complain to the Data Protection Board of India.

Your agreement

By acknowledging this notice, you agree that [clinic name] may record and use your data as described above. You can withdraw your agreement for anything that is optional at any time, by telling us.

Version [1.0], [date]

Contact

Write to our Grievance Officer with any question, request or complaint about this page or your data.

Company
Substrate Labs
Registered address
Mumbai, India
Email
support@substrates.in
Replies
Privacy requests within 30 days. Complaints acknowledged within 24 hours and resolved within 15 days.

If you are not satisfied with our answer, you can complain to the Data Protection Board of India.

Change history

  1. First published.