Internal Regulations

1.PURPOSE

These Internal Regulations (hereinafter referred to as the "Regulations") of Aistė Čikotienė Neurology Clinic (hereinafter referred to as the "Clinic") establish guidelines governing relationships among employees, patients, and other individuals visiting the Clinic, and outline their primary rights and obligations.

2.SCOPE

All employees, patients, and other individuals visiting the Clinic are required to be familiar with and adhere to these Regulations.

3. PROCEDURES

3.1. GENERAL PROVISIONS

The Clinic is a private healthcare institution providing healthcare services (hereinafter referred to as "Services"). Relationships between Clinic employees, patients, and other individuals visiting the Clinic are based on principles of mutual respect, understanding, assistance, and the safeguarding of patient rights.

The Clinic operates in compliance with the laws and other regulatory acts of the Republic of Lithuania, governing the activities of healthcare institutions, as well as internal regulatory documents (policies, rules, guidelines, etc.) and these Regulations.

The Regulations are publicly posted in the Clinic in an area accessible to patients.

3.2. CLINIC WORKING HOURS

Clinic working hours:

• Weekdays: from 3:30 PM to 7:00 PM;
• Closed on Saturdays, Sundays, and public holidays. On Saturdays, Sundays, and public holidays, the Clinic's administration and support services are also unavailable.

3.3. PROCEDURE FOR CONSULTING CLINIC

Information about Services, service provision procedures, pricing, availability, and practicing doctors is provided on the Clinic's website at https://www.aistecikotiene.lt/lt. Patients can also obtain information verbally or in writing by contacting the Clinic.

A patient will only be served if the Clinic is qualified and able to provide the required Services.

Patients requiring Services must schedule an appointment in advance.

Appointments can be scheduled:

• Through the online registration system at https://www.aistecikotiene.lt/lt, under the “Appointment Registration” section;
• By visiting the Clinic (during working hours).

During registration, patients are provided with information about the working hours of the Clinic's doctors, available Services, pricing, and potential appointment times. Patients seeking Services must provide their name, contact phone number, and/or email at the time of registration. Registration is completed only if the patient consents to having their name, contact information, selected Services, and appointment time entered into the Clinic’s electronic database. Personal data in this database is managed according to the Clinic’s Data Protection Policy.

Patients must inform the Clinic as early as possible to cancel their appointment if they (i) are unable to attend at the scheduled time or (ii) wish to cancel the requested Services. If the appointment is canceled at least 24 hours prior to the scheduled service time, any payment made will be refunded to the payer’s account, or, at the patient’s request, applied to other Services. If the appointment is not canceled at least 24 hours prior to the scheduled service time, it becomes non-cancellable, and any payment made is non-refundable.

If a patient is unable to attend or misses their scheduled appointment, they must register again if they wish to reschedule.

For every patient receiving Services at the Clinic, an electronic outpatient visit description is created.

Upon arrival at the Clinic, the patient must present a valid ID (such as a passport or ID card). Foreign nationals without a passport or ID card may provide another valid form of identification. Original documents must be presented.

To receive Services, patients must review these Regulations and confirm in writing on Clinic documents that they have understood them. Patients must also review, complete, and sign any additional forms (consents, forms, etc.). If the patient cannot sign the required documents due to age, health, or other special circumstances outlined in legal acts, an accompanying representative must sign on their behalf.

3.4. LIST AND RANGE OF PAID SERVICES PROVIDED AT THE CLINIC

The Clinic provides the Services specified in its healthcare license and service price lists. A copy of the Clinic’s healthcare license is available for review at the Clinic.

Information on the Services provided, pricing, and terms is outlined in the service price lists and other related documents, accessible on the website at https://www.aistecikotiene.lt/lt, and further information can be provided at the Clinic.

Patients are required to pay for the Services at the time of registration. In each case, the patient must confirm their agreement to receive paid Services; otherwise, the Services will not be provided. Patients pay for Services based on the rates in effect at the Clinic at the time of service.

Payment for Services can be made by bank transfer or in cash. After payment, a payment confirmation document is issued to the patient, and upon request, an invoice can be provided.

3.5. PATIENT RIGHTS AND RESPONSIBILITIES IN THE CLINIC

Patients have rights as outlined in these Rules and the laws of the Republic of Lithuania.

Patients must use their rights honestly, without abuse, and respect the rights and legitimate interests of others.

Patient rights may be restricted to the extent provided by law and these Rules.

Patients must adhere to the responsibilities specified in these Rules and the laws of the Republic of Lithuania.

If a patient violates their obligations, thereby endangering their own or other patients' health and life, or impedes others from receiving quality services, the Clinic may refuse to provide services or discontinue service provision.

3.5.1. PATIENT RIGHTS

Right to Quality Healthcare:

• Patients have the right to quality healthcare without discrimination based on gender, age, race, nationality, language, origin, social status, beliefs, opinions, sexual orientation, genetic traits, disability, or other unjustified grounds.
• Each Service is provided in accordance with relevant professional duties and standards.

Right to Respect:

• Patients have the right to respectful, courteous service, dignified conditions, and respectful treatment.

Right to Consultation:

• Patients may consult Clinic staff on all matters related to the Services provided and may approach Clinic administration with disputes to receive answers to their queries.

Right to Privacy:

• The patient’s privacy is inviolable.
• Information about a patient’s life facts may only be collected with their consent and when necessary to provide services.
• All information regarding a patient’s presence, health status, and treatment at the Clinic is confidential, even after death, unless otherwise specified by law.

Right to Choose:

• Patients have the right to discuss services with Clinic specialists and agree or disagree. Agreement or disagreement must be confirmed in writing.

Right to Information:

• Patients must be informed of the Rules and procedures applicable to their stay in the Clinic.
• Patients have the right to information about the services provided, costs, and availability.
• They may request information about the healthcare provider (name, surname, position, qualifications) and details on their health status, diagnosis, and available treatments.

Right to Access Medical Records:

• Patients may access and receive copies of their medical records.

Right Not to Know:

• Information about the patient's health, diagnosis, and potential risks may not be given against their will. Refusal must be expressed clearly in writing.

Right to Know Service Fees:

• Patients have the right to be informed about all costs related to the services provided.

Right to File a Complaint:

• If a patient believes their rights have been violated, they may file a complaint with the Clinic and receive a response according to the law.

Right to Compensation:

• Patients or other authorized individuals have the right to compensation for damages due to violations of their rights in receiving services.
• Claims must be filed with the Patient Health Damage Assessment Commission under the Ministry of Health, following procedures outlined in the Government-approved rules for compensation of material and non-material damage caused to patient health.

3.5.2. PATIENT RESPONSIBILITIES

The patient is required to take care of their own health, use their rights honestly and responsibly, and cooperate with the healthcare professionals and staff at the Clinic.

The patient must adhere to the appointment time confirmed during registration. If the patient is unable to attend at the agreed time, they must inform the Clinic in advance (no later than 24 hours before the scheduled service time).

If a patient misses their scheduled appointment or is unable to attend at that time, they must re-register to receive services at a different time.

The patient must treat the Clinic staff and other patients with respect and decorum. They are prohibited from creating noise or otherwise disrupting the Clinic’s operations.

To receive services, the patient must present a valid identity document. If the patient refuses to present an identity document, services will not be provided.

The patient must fill out and acknowledge with a signature all presented medical documents (forms, consents, etc.). Services will not be provided if the patient refuses to complete or sign the required documents.

Upon receiving information about the services provided to them, the patient must confirm their consent or refusal in writing. Services will not be provided if they refuse to confirm.

To receive information about the services provided, their results, or any other information the Clinic holds about the patient, the patient must present an identity document.

The patient must handle Clinic property with care. It is prohibited to damage, destroy, or remove any property or materials belonging to the Clinic.

The patient is obligated to provide accurate, comprehensive information to Clinic specialists about their health, past illnesses, surgeries, medications used, allergies, hereditary conditions, and any other relevant information needed to deliver appropriate healthcare services.

Filming, photographing, or recording audio within the Clinic is prohibited without prior consent from the Clinic. Violating this requirement may result in the denial or immediate termination of services. The Clinic may require any person violating this restriction to leave the premises and destroy all recorded material. If the material was disseminated or made public, the person must ensure its removal or destruction.

The patient is responsible for paying promptly for any paid services received, based on current rates.

The patient must adhere to personal hygiene requirements.

The patient must comply with the instructions given by Clinic staff.

The patient must follow the prescribed treatments and recommendations provided by Clinic specialists or formally decline the services.

The patient is liable for any damage caused to the Clinic or its employees, in accordance with Lithuanian law.

The patient must not be intoxicated or under the influence of narcotics or psychotropic substances when receiving services. The Clinic reserves the right to refuse services to patients who are intoxicated or suspected of being intoxicated. The patient is prohibited from smoking, consuming alcohol, or using narcotic and/or psychotropic substances within the Clinic.

If a patient violates their responsibilities, creating a threat to their own or others' health and life, or obstructs others from receiving quality services, the provision of services may be discontinued.

3.6. PROCEDURE FOR RESOLVING DISPUTES AND CONFLICTS BETWEEN THE CLINIC AND THE PATIENT

The patient is assured the right to express, in writing or orally, their opinion regarding the quality of services provided, staff competence, Clinic operations, and more.

If the patient believes their rights have been violated, or if they are dissatisfied with the quality of services provided, they may contact the Clinic. The Clinic always aims to resolve conflicts with the patient through mutual agreement.

A patient who believes their rights are being violated at the Clinic has the right to submit a complaint:

• A complaint may be submitted by the patient or their representative. Only signed complaints specifying the patient’s full name, address, and contact information, as well as the essence of the complaint, will be considered. If the complaint is submitted by a representative, the representative’s full name, address, supporting documentation of representation, and the patient’s name on whose behalf they are acting must be included. Complaints that do not meet these requirements will not be reviewed and will be returned to the patient with an explanation of the reason.
• The patient must present an identity document with the complaint. If sent by mail or courier, a copy of the patient’s identity document certified by a notary or lawyer representing the patient must be included. A representative of the patient submitting the complaint must provide an identity and representation document.
• Upon receiving a patient’s complaint, the Clinic must review it and notify the patient in writing (by sending or delivering it if the patient visits the Clinic) of the outcome of the review within 20 working days.
• If the patient (or their representative) is dissatisfied with the outcome of their complaint, they may address relevant state institutions or a court as provided by law.

A patient with concerns about service accessibility and quality violations may appeal to the State Accreditation Health Care Activity Control Authority under the Ministry of Health; for issues related to mandatory health insurance, they may contact the National Health Insurance Fund under the Ministry of Health; and for issues relating to bioethics standards, they may contact the Lithuanian Bioethics Committee. The patient may approach these institutions if they disagree with the Clinic’s decision after reviewing the complaint or if the complaint is not reviewed within the specified timeframe. The patient also retains the right to approach the court directly or appeal the actions or inaction of these institutions.

For compensation of damages, the patient must apply to the Health Damage Compensation Commission under the Ministry of Health in accordance with the procedure for material and non-material damage compensation approved by the Government of the Republic of Lithuania.

3.7. PROCEDURE FOR ACCESSING MEDICAL RECORDS, REQUESTING AND ISSUING COPIES/EXTRACTS

Patients or their representatives who wish to review medical records and/or obtain copies or extracts, including diagnoses and treatment descriptions, must submit a request (verbally or in writing) containing:

• The requester’s full name, residential address, phone number, and/or email address.
• The type, scope, and intended use of the requested information.

Representatives must also provide:

• Documentation confirming representation (a power of attorney and a copy of the representative's identification document).
• Guardians or custodians must submit a copy of their identification and a court decision establishing guardianship.

Procedure for submitting requests and documents:

• When the request is made in person, the requester must present identification to the accepting staff.
• When submitted by mail or courier, copies of identification and representative documents must be notarized, consularly certified, or endorsed by a local official, or, if represented by an attorney, endorsed by the attorney.
• When submitted electronically, an identification document is not required, but the request and documents must be signed with a qualified electronic signature or via secure electronic means ensuring the requester's identity and document integrity.

Upon request, patients may review their health history or other medical documents in person at the Clinic, provided they show identification, except when such access could harm the patient's health or endanger life. Medical document reviews are conducted at the Clinic where the patient most recently received treatment or where paper medical documents are stored.

Healthcare professionals must explain the meaning of entries in a patient’s medical documents according to their expertise.

If justified, the Clinic will, within 15 business days, correct, supplement, complete, remove, or amend inaccurate, incomplete, ambiguous, or irrelevant data upon the patient’s request.

After submitting a request and required documents per data protection laws, the Clinic must issue copies of medical records and descriptions of diagnoses and treatment. This right may only be restricted by Lithuanian law.

Medical records in Lithuanian are provided upon request by the treating physician to the patient who presents identification. Extracts from medical documents are prepared at the patient's expense according to Clinic rates. If the first request is made for medical record copies, diagnoses, or treatment descriptions, these are provided at the Clinic's expense. Extracts and copies are prepared within one business day and delivered by one of the following means:

• e-sveikata portal,
• encrypted email,
• registered mail,
• or in person at the Clinic.

In exceptional cases where a request cannot be fulfilled within one business day, the patient or representative is informed promptly, with an estimated completion date provided.

Extracts and copies of medical records are only provided to the patient with identification or an authorized representative with the required documents as outlined in this section.

At the patient’s or representative's expense, the Clinic may send ordered medical record extracts and copies by registered mail to the address provided in the request.

• The shipment may be delivered to any person at the specified address based on the mail service provider's policies.
• The Clinic reserves the right to select any mail or courier service provider. The Clinic is not responsible for delivery time or quality; any claims should be addressed to the mail or courier service provider.

Extracts and copies are not provided to unauthorized individuals unless permitted by law.

3.8. PROCEDURE FOR PROVIDING INFORMATION ON PATIENT'S HEALTH STATUS TO PATIENT AND FAMILY

The treating physician provides information on the patient’s health status, diagnosis, and medical test results. While explaining the treatment, the physician details its course, potential results, alternative treatments, risks, complications, side effects, prognosis, and other factors affecting the patient’s decision to accept or refuse treatment, as well as the consequences of refusing. This information is presented in an age- and health-appropriate manner, with medical terms explained in plain language.

Health status information is only withheld from a patient if the patient explicitly declines (a formal statement is required) or if it could seriously harm the patient’s health or endanger life. In such cases, the information is provided to the patient’s representative.

Medical professionals must explain the meaning of entries in the patient's medical records according to their expertise.

Information about a patient’s visit, health status, diagnosis, and test or treatment data is not provided over the phone. Information is only provided by email in exceptional cases and following the Clinic’s policy (the patient must specify an email address in advance, and the information is sent encrypted). Documents signed with an electronic signature sent by the patient by email are treated as standard written documents and handled according to standard procedures.

Health information of a patient unable to reasonably assess their interests is provided to the patient’s spouse, cohabiting partner, parents (adoptive parents), or adult children upon request.

Health information, including visit details, diagnosis, and treatment, is not provided to unauthorized persons, except as permitted by law.

3.9. PROCEDURE FOR PROVIDING PATIENT INFORMATION TO STATE INSTITUTIONS AND OTHER ORGANIZATIONS

All patient information is confidential and can only be shared with written consent from the patient, except when it is provided for official purposes to institutions such as healthcare facilities where the patient has received treatment, those conducting medical examinations, or when the patient registers for healthcare services. Information may also be shared with regulatory bodies overseeing healthcare services, the courts, the prosecutor's office, and other institutions authorized by Lithuanian law.

Information for institutions is provided following the "Procedure for Providing Patient Information to State Institutions and Other Organizations," as approved by the Lithuanian Minister of Health on February 1, 2001, Order No. 65, "On the Approval of the Procedure for Providing Patient Information to State Institutions and Other Organizations and Defining Criteria for Health Information Confidentiality."

3.10. PATIENT VISIT PROCEDURE

Upon entering the Clinic, patients and other visitors must remove their outerwear (e.g., coats, jackets) and leave them in the designated area instructed by the Clinic's receptionist. It is advised not to leave any documents, keys, or valuables (such as phones, money, jewelry, or payment cards) in coats. The Clinic does not safeguard items left in clothing and is not responsible for them.

When arriving, patients must present identification, complete, and sign all necessary documents as directed by Clinic staff. Patients are seen at their scheduled registration time. If the Clinic cannot accommodate the patient exactly at the scheduled time, the patient is informed of the potential wait time and offered to wait in the lobby. If the patient declines, another appointment is arranged based on the patient’s preferences and the Clinic's operating hours.

The Clinic may refuse to see a patient who is more than 15 minutes late if it would disrupt the schedule of other patients.

If services cannot be completed in a single visit, a follow-up appointment can be immediately scheduled to ensure continuity of care.

Due to the specialist’s workload, illness, or unforeseen circumstances, scheduled appointments and/or services may be canceled or rescheduled to another day. The new appointment time will be arranged with the patient by phone.

3.11. PERSONAL DATA PROCESSING

The Clinic processes patient personal data (e.g., name, phone number, date of birth, email address, personal identification number, home address, health data) when providing services.

For more details on data processing, please see the "Notice on Personal Data Processing" (https://www.aistecikotiene.lt/lt/nuostatos-ir-salygos).

3.12. PROVISIONS REGARDING OCCUPATIONAL SAFETY LAWS, OTHER LEGISLATION, AND REGULATIONS

The Clinic Director is responsible for ensuring workplace safety.

Clinic staff are responsible for following occupational safety regulatory documents.

Occupational, fire, and electrical safety regulations are observed on-site, in compliance with the Lithuanian Law on Health and Safety at Work, other applicable legislation, and Clinic-specific policies, procedures, and regulations.

Smoking is prohibited on Clinic premises.

Being under the influence of alcohol, drugs, or toxic substances is prohibited in the Clinic.

Staff in direct contact with patients must wear clean, neat medical attire.

3.13. FINAL PROVISIONS

These rules are posted in a visible location at the Clinic, and an electronic version is available on the Clinic's website at https://www.aistecikotiene.lt/lt/nuostatos-ir-salygos.

If needed, the rules may be revised, supplemented, or amended.