By completing this online request, you provide your consent to process your and your dependant’s personal information for purposes as set out below.
While your consent is voluntary, it is a requirement for you to register for and receive the COVID-19 vaccination at one of our vaccination sites.
Momentum Metropolitan will protect your personal information and will adhere to the Protection of Personal Information Act, 2013 when processing your personal information.
Your personal information will be processed for the purpose of registering you and your dependants for a vaccination appointment at one of the designated Momentum Metropolitan sites (currently Durban, Cape Town, Qheberha, Sandton and Centurion) and will be shared with the staff on site in order to assist you.
The National Department of Health (NDoH) has developed an Electronic Vaccine Data System (EVDS) to support the COVID-19 vaccination rollout. You are required to register on the EVDS site and provide the relevant information for this purpose.
Your information will be shared with EVDS to support the COVID-19 vaccination rollout in South Africa. The EVDS will be used to capture COVID-19 vaccination events digitally and provide data to the NDoH data analytics platform to monitor and report on.
1. I authorise and give consent to Momentum Metropolitan to collect, store, collate, process, share and further process my personal information, including health information, and that of my dependants, for purposes of registration for the vaccine.
2. If I have consented to the disclosure of my personal information, Momentum Metropolitan may further process my personal information in accordance with applicable privacy and data protection legislation and provide it to any natural or juristic person (which could include a company, corporation, state, or agency of a state, association, trust or partnership) or if a contractual relationship exists between Momentum Metropolitan and their service providers which requires them to do so.
3. I authorise and consent to my personal information and my dependants’ personal information, including demographic data and geographical data, and where applicable, being shared with authorised third parties such as the National Department of Health and healthcare providers, provided that it complies with applicable privacy and data protection legislation.
4. Momentum Metropolitan ensures that your personal information is safeguarded against the risk of loss or damage and against the unauthorised or unlawful access.
I give permission for my and my dependant’s information to be shared for the intended purposes of receiving the COVID 19 vaccine to be administered to the person/s on my medical scheme membership and for a record of the vaccination to be entered into the EDVS system for care co-ordination and to monitor nationwide vaccination coverage. Further, I agree that the information provided is true and correct.
For information on the National Department of Health’s EVDS system, please click on the link below: