www.apolloclinic.com
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188.114.96.3
Public Scan
Submitted URL: http://www.apolloclinic.com/
Effective URL: https://www.apolloclinic.com/
Submission: On June 17 via api from GB — Scanned from NL
Effective URL: https://www.apolloclinic.com/
Submission: On June 17 via api from GB — Scanned from NL
Form analysis
11 forms found in the DOMPOST https://www.apolloclinic.com/search
<form method="post" action="https://www.apolloclinic.com/search" novalidate="">
<input class="search_text" id="search_text" name="search_text" type="text" placeholder="Site Search"> <input type="hidden" name="searchfor" value="all">
<button type="submit" class="search_submit">Search</button>
</form>
Name: form1 — POST download.php
<form action="download.php" method="post" name="form1" id="form1" target="_blank">
<div class="form_field full_width">
<input type="text" name="visit_id" id="visit_id" placeholder="User Name" class="inpt" style="border: 1px solid #ccc;"> <span class="user_icon"></span>
</div>
<div class="form_field full_width">
<input type="password" name="passcode" id="passcode" placeholder="Password" autocomplete="off" class="inpt" style="border: 1px solid #ccc;"> <span class="password_icon"></span>
</div>
<span id="spanDownload">
<p>(Please refer to bill for user name & password)</p>
</span>
</form>
Name: form2 — POST download.php
<form action="download.php" method="post" name="form2" id="formDownload" target="_blank">
<div class="form_field full_width">
<input type="text" name="visit_id" id="visit_id2" placeholder="User Name" class="inpt" style="border: 1px solid #ccc;"> <span class="user_icon"></span>
</div>
<div class="form_field full_width">
<input type="password" name="passcode" id="passcode2" placeholder="Password" autocomplete="off" class="inpt" style="border: 1px solid #ccc;"> <span class="password_icon"></span>
</div>
<span id="spanDownload2">
<p>(Please refer to bill for user name & password)</p>
</span>
</form>
post
<form onsubmit="return submitSubscribe()" action="post">
<input type="text" id="newsletter_email" name="newsletter_email" placeholder="Email Address" class="sb-search-input"> <span class="sb-icon-search" id="subscribe_load" style="display: none">Loading...</span>
<button class="sb-icon-search" type="submit" id="subscribe_btn">Subscribe</button>
</form>
Name: requestcall — POST https://www.apolloclinic.com/form/requestCall
<form onsubmit="return false" novalidate="novalidate" action="https://www.apolloclinic.com/form/requestCall" method="post" enctype="multipart/form-data" name="requestcall" id="trequestcall" role="form">
<div class="request_from show">
<div class="modal-body">
<div class="row">
<div class="col-lg-12">
<div class="form-group">
<label for="fullname">Full name <strong style="color: #F00">*</strong></label>
<input type="text" class="form-control" id="rfullname" name="rfullname" placeholder="Full name" required="">
</div>
</div>
</div>
<div class="row">
<div class="col-lg-12">
<div class="form-group">
<label for="mobile">Mobile <strong style="color: #F00">*</strong></label>
<input type="text" class="form-control" id="rmobile" name="rmobile" placeholder="Mobile" required="">
</div>
</div>
</div>
</div>
<div class="modal-footer trequestcallload">
<button type="button" class="btn btn-default" data-dismiss="modal">Cancel</button>
<button type="submit" class="btn btn-primary">Submit</button>
</div>
<div class="modal-footer trequestcallloading" style="display: none">Submitting the form Please wait...</div>
</div>
<div class="sucess_msg hide"></div>
<div class="error_msg hide"></div>
</form>
<form class="form4" id="form4" style="text-align:center;">
<input type="phone" id="phone" name="user_phone" placeholder="Mobile Number" class="user_phone inpt" style="margin:5px;">
<br>
<button type="submit" class="btn btn-primary" style="float:none;margin:5px;">Generate OTP</button>
</form>
<form class="form2" id="form2" style="display:none;text-align:center;">
<input type="number" id="otp" name="user_otp" placeholder="Enter OTP" style="text-align:center;margin:5px;">
<input type="hidden" name="user_phone_otp" class="user_phone_otp">
<button type="submit" class="btn btn-primary" style="margin:5px;float:none;">Verify OTP</button>
</form>
<form id="quick_appointment_widget" class="quick_appointment_widget quick_appointment_widget_form">
<div class="appointment_response"></div>
<div class="row">
<div class="col-md-6 col-sm-6 col-xs-6">
<div class="form-group">
<input type="text" name="fname" id="" class="form-control" placeholder="First Name">
</div>
</div>
<div class="col-md-6 col-sm-6 col-xs-6">
<div class="form-group">
<input type="text" name="lname" id="" class="form-control" placeholder="Last Name">
</div>
</div>
<div class="col-md-6 col-sm-6 col-xs-6">
<div class="form-group">
<input type="email" name="email" id="" class="form-control" placeholder="Email">
</div>
</div>
<div class="col-md-6 col-sm-6 col-xs-6">
<div class="form-group">
<input type="tel" name="phone" id="" class="form-control" placeholder="Phone No.">
</div>
</div>
<div class="col-md-6 col-sm-6 col-xs-6">
<div class="form-group">
<input type="text" name="dob" id="dp1718609775705" class="form-control dob_field hasDatepicker" placeholder="Date of Birth">
</div>
</div>
<div class="col-md-6 col-sm-6 col-xs-6">
<div class="form-group">
<select name="gender" class="form-control" id="field_gender">
<option value="">Select Gender</option>
<option value="1">Male</option>
<option value="2">Female</option>
</select>
</div>
</div>
<div class="col-md-6 col-sm-6 col-xs-6">
<div class="form-group">
<select name="cityId" class="form-control field_city" data-form-class=".quick_appointment_widget_form">
<option value="0">Select City</option>
<option value="3015" data-city="Bangalore">Bangalore</option>
<option value="4413" data-city="Chandigarh">Chandigarh</option>
<option value="1" data-city="Chennai">Chennai</option>
<option value="4791" data-city="Coimbatore">Coimbatore</option>
<option value="5867" data-city="Dehradun">Dehradun</option>
<option value="2741" data-city="Delhi">Delhi</option>
<option value="2995" data-city="Dhanbad">Dhanbad</option>
<option value="5899" data-city="Ghaziabad">Ghaziabad</option>
<option value="5907" data-city="Gorakhpur">Gorakhpur</option>
<option value="545" data-city="Guntur">Guntur</option>
<option value="2899" data-city="Gurugram">Gurugram</option>
<option value="2207" data-city="Guwahati">Guwahati</option>
<option value="12" data-city="Hyderabad">Hyderabad</option>
<option value="3371" data-city="Kannur">Kannur</option>
<option value="13" data-city="Kolkata">Kolkata</option>
<option value="5955" data-city="Lucknow">Lucknow</option>
<option value="3989" data-city="Mumbai">Mumbai</option>
<option value="3175" data-city="Mysore">Mysore</option>
<option value="3991" data-city="Nagpur">Nagpur</option>
<option value="3999" data-city="Nasik">Nasik</option>
<option value="4007" data-city="Pune">Pune</option>
<option value="6388" data-city="Raipur">Raipur</option>
<option value="1549" data-city="Rangareddy">Rangareddy</option>
<option value="2867" data-city="Surat">Surat</option>
<option value="4037" data-city="Thane">Thane</option>
<option value="1827" data-city="Tirupati">Tirupati</option>
<option value="3571" data-city="Trivandrum">Trivandrum</option>
<option value="2873" data-city="Vadodara">Vadodara</option>
<option value="1983" data-city="Visakhapatnam">Visakhapatnam</option>
<option value="3015" data-city="Bangalore">Bangalore</option>
<option value="4413" data-city="Chandigarh">Chandigarh</option>
<option value="1" data-city="Chennai">Chennai</option>
<option value="4791" data-city="Coimbatore">Coimbatore</option>
<option value="5867" data-city="Dehradun">Dehradun</option>
<option value="2741" data-city="Delhi">Delhi</option>
<option value="2995" data-city="Dhanbad">Dhanbad</option>
<option value="5899" data-city="Ghaziabad">Ghaziabad</option>
<option value="5907" data-city="Gorakhpur">Gorakhpur</option>
<option value="545" data-city="Guntur">Guntur</option>
<option value="2899" data-city="Gurugram">Gurugram</option>
<option value="2207" data-city="Guwahati">Guwahati</option>
<option value="12" data-city="Hyderabad">Hyderabad</option>
<option value="3371" data-city="Kannur">Kannur</option>
<option value="13" data-city="Kolkata">Kolkata</option>
<option value="5955" data-city="Lucknow">Lucknow</option>
<option value="3989" data-city="Mumbai">Mumbai</option>
<option value="3175" data-city="Mysore">Mysore</option>
<option value="3991" data-city="Nagpur">Nagpur</option>
<option value="3999" data-city="Nasik">Nasik</option>
<option value="4007" data-city="Pune">Pune</option>
<option value="6388" data-city="Raipur">Raipur</option>
<option value="1549" data-city="Rangareddy">Rangareddy</option>
<option value="2867" data-city="Surat">Surat</option>
<option value="4037" data-city="Thane">Thane</option>
<option value="1827" data-city="Tirupati">Tirupati</option>
<option value="3571" data-city="Trivandrum">Trivandrum</option>
<option value="2873" data-city="Vadodara">Vadodara</option>
<option value="1983" data-city="Visakhapatnam">Visakhapatnam</option>
<option value="3015" data-city="Bangalore">Bangalore</option>
<option value="4413" data-city="Chandigarh">Chandigarh</option>
<option value="1" data-city="Chennai">Chennai</option>
<option value="4791" data-city="Coimbatore">Coimbatore</option>
<option value="5867" data-city="Dehradun">Dehradun</option>
<option value="2741" data-city="Delhi">Delhi</option>
<option value="2995" data-city="Dhanbad">Dhanbad</option>
<option value="5899" data-city="Ghaziabad">Ghaziabad</option>
<option value="5907" data-city="Gorakhpur">Gorakhpur</option>
<option value="545" data-city="Guntur">Guntur</option>
<option value="2899" data-city="Gurugram">Gurugram</option>
<option value="2207" data-city="Guwahati">Guwahati</option>
<option value="12" data-city="Hyderabad">Hyderabad</option>
<option value="3371" data-city="Kannur">Kannur</option>
<option value="13" data-city="Kolkata">Kolkata</option>
<option value="5955" data-city="Lucknow">Lucknow</option>
<option value="3989" data-city="Mumbai">Mumbai</option>
<option value="3175" data-city="Mysore">Mysore</option>
<option value="3991" data-city="Nagpur">Nagpur</option>
<option value="3999" data-city="Nasik">Nasik</option>
<option value="4007" data-city="Pune">Pune</option>
<option value="6388" data-city="Raipur">Raipur</option>
<option value="1549" data-city="Rangareddy">Rangareddy</option>
<option value="2867" data-city="Surat">Surat</option>
<option value="4037" data-city="Thane">Thane</option>
<option value="1827" data-city="Tirupati">Tirupati</option>
<option value="3571" data-city="Trivandrum">Trivandrum</option>
<option value="2873" data-city="Vadodara">Vadodara</option>
<option value="1983" data-city="Visakhapatnam">Visakhapatnam</option>
<option value="3015" data-city="Bangalore">Bangalore</option>
<option value="4413" data-city="Chandigarh">Chandigarh</option>
<option value="1" data-city="Chennai">Chennai</option>
<option value="4791" data-city="Coimbatore">Coimbatore</option>
<option value="5867" data-city="Dehradun">Dehradun</option>
<option value="2741" data-city="Delhi">Delhi</option>
<option value="2995" data-city="Dhanbad">Dhanbad</option>
<option value="5899" data-city="Ghaziabad">Ghaziabad</option>
<option value="5907" data-city="Gorakhpur">Gorakhpur</option>
<option value="545" data-city="Guntur">Guntur</option>
<option value="2899" data-city="Gurugram">Gurugram</option>
<option value="2207" data-city="Guwahati">Guwahati</option>
<option value="12" data-city="Hyderabad">Hyderabad</option>
<option value="3371" data-city="Kannur">Kannur</option>
<option value="13" data-city="Kolkata">Kolkata</option>
<option value="5955" data-city="Lucknow">Lucknow</option>
<option value="3989" data-city="Mumbai">Mumbai</option>
<option value="3175" data-city="Mysore">Mysore</option>
<option value="3991" data-city="Nagpur">Nagpur</option>
<option value="3999" data-city="Nasik">Nasik</option>
<option value="4007" data-city="Pune">Pune</option>
<option value="6388" data-city="Raipur">Raipur</option>
<option value="1549" data-city="Rangareddy">Rangareddy</option>
<option value="2867" data-city="Surat">Surat</option>
<option value="4037" data-city="Thane">Thane</option>
<option value="1827" data-city="Tirupati">Tirupati</option>
<option value="3571" data-city="Trivandrum">Trivandrum</option>
<option value="2873" data-city="Vadodara">Vadodara</option>
<option value="1983" data-city="Visakhapatnam">Visakhapatnam</option>
</select>
</div>
</div>
<div class="col-md-6 col-sm-6 col-xs-6">
<div class="form-group">
<span id="field_clinics-loader" class="field-loader field_clinics-loader"><i class="fa fa-spinner fa-spin"></i></span>
<select name="hospitalId" class="form-control field_clinics" data-form-class=".quick_appointment_widget_form">
<option value="0">Select Clinic</option>
</select>
</div>
</div>
<div class="col-md-6 col-sm-6 col-xs-6">
<div class="form-group">
<span id="field_speciality-loader" class="field-loader field_speciality-loader"><i class="fa fa-spinner fa-spin"></i></span>
<select name="specialityId" class="form-control field_speciality" data-form-class=".quick_appointment_widget_form">
<option value="0">Select Speciality</option>
</select>
</div>
</div>
<div class="col-md-6 col-sm-6 col-xs-6">
<div class="form-group">
<span id="field_doctor-loader" class="field-loader field_doctor-loader"><i class="fa fa-spinner fa-spin"></i></span>
<select name="doctorId" class="form-control field_doctor" data-form-class=".quick_appointment_widget_form">
<option value="0">Select Doctor</option>
</select>
</div>
</div>
<div class="col-md-6 col-sm-6 col-xs-6">
<div class="form-group dates-wrap">
<span class="field-loader appointmentpicker-loader"><i class="fa fa-spinner fa-spin"></i></span>
<input type="text" name="date" class="form-control appointmentpicker fa fa-arrow-right" placeholder="Select Date" readonly="readonly" data-form-class=".quick_appointment_widget_form">
<span class="dates-preloader" style="display: none;">Loading Available Dates...</span>
</div>
</div>
<div class="col-md-6 col-sm-6 col-xs-6 slots-container">
<div class="form-group">
<span class="field-loader field_slot-loader"><i class="fa fa-spinner fa-spin"></i></span>
<select name="slotTime" class="form-control field_slot" data-form-class=".quick_appointment_widget_form">
<option value="0">Select Slot</option>
</select>
<span class="slots-preloader" style="display: none;">Loading Available Slots...</span>
<input type="hidden" name="slotId" class="field_slot_id" value="" data-form-class=".quick_appointment_widget_form">
</div>
</div>
<div class="col-md-6">
<div class="form-group">
<select name="mode" class="form-control" id="field_appointment_mode">
<option value="">Select Mode</option>
<option value="Physical Consult">Physical Consult</option>
<option value="Tele Consult">Tele Consult</option>
</select>
</div>
</div>
<div class="col-md-12 consent-checkbox">
<input type="checkbox" name="concern" value="true" id="concern"><label for="true"> I Agree
"<a type="button" data-toggle="modal" class="btn-modal-consent" data-target="#concernModal" rel="nofollow" href="#">Patient Information Consent</a>"</label>
</div>
<div class="col-md-12 col-sm-12 col-xs-12">
<input type="hidden" name="cityName" class="cityName" id="cityName" value="">
<input type="hidden" name="specialityName" class="specialityName" id="" value="">
<input type="hidden" name="doctorName" class="doctorName" id="" value="">
<input type="hidden" name="hospitalName" class="hospitalName" id="" value="">
<input type="hidden" name="appointment_type" class="appointment_type appointment_type_input" value="">
<input type="hidden" name="action" value="ConfirmConsultationAppointment">
<button class="btn btn-primary btn-confirm-appointment" data-form-class=".quick_appointment_widget_form">Submit</button>
<button type="button" class="btn btn-default" data-dismiss="modal">Cancel</button>
</div>
</div>
</form>
Name: bookappnew — POST #
<form onsubmit="return false" novalidate="novalidate" action="#" method="post" enctype="multipart/form-data" name="bookappnew" id="bookapp" role="form" style="display:none;">
<div class="app_form show">
<div class="modal-body" style="padding: 15px 15px 0px 15px;">
<div class="row">
<div class="col-lg-6">
<div class="form-group">
<input type="text" class="form-control" id="fullname" name="fullname" placeholder="Full Name *" required="">
</div>
</div>
<div class="col-lg-6">
<div class="form-group">
<input type="text" class="form-control" name="phonenumber" id="phonenumber" placeholder="Mobile *" required="">
</div>
</div>
</div>
<div class="row">
<div class="col-lg-6">
<div class="form-group">
<input type="email" class="form-control" name="email" id="email" placeholder="Email Address *" required="">
</div>
</div>
<div class="col-lg-6">
<div class="form-group countryselecting">
<select id="hcountry" class="select2 appAddresscountry hspeccountry" name="country" onchange="countryChange(this.value)" style="width: 100%" required="">
<option value="">Select Country</option>
<option value="India">India</option>
<option value="Qatar">Qatar</option>
</select>
</div>
</div>
</div>
<div class="row">
<div class="col-lg-6">
<div class="form-group selecting">
<select id="address" class="select2 appAddress appAddressdyn" onchange="areaChange(this.value)" name="address" style="width: 100%" required="">
<option value="">Please Select City</option>
</select>
</div>
</div>
<div class="col-lg-6">
<div class="form-group selecting">
<select id="harea" class="select2 appAddress harea" name="area" onchange="specialityChange(this.value)" style="width: 100%" required="">
<option value="">Select Clinic Location</option>
</select>
</div>
</div>
</div>
<div class="row hdselectforser">
<div class="col-lg-12">
<div class="form-group selecting">
<select id="hspecmainserv" class="select2 clshspecmainserv" name="homeservice" style="width: 100%" required="">
<option value="">Select Service</option>
<option value="Consultations">Consultations</option>
<option value="Diagnostics">Diagnostics</option>
<option value="Health_checks">Health checks</option>
<option value="Dental">Dental</option>
<option value="Physiotherapy">Physiotherapy</option>
<option value="Vaccinations">Vaccinations</option>
</select>
</div>
</div>
</div>
<div class="row">
<div class="col-lg-6">
<div class="form-group">
<input type="text" class="form-control alldatepicker hasDatepicker" id="appoinment2" name="appoinment" placeholder="Appointment" required="" onchange="dateChangenew(this.value)">
</div>
</div>
<div class="col-lg-6">
<div class="form-group selecting">
<select id="clinictime" class="select2 appAddress clinictime" name="clinicTime" style="width: 100%" required="">
<option value="">Select Time Slot</option>
<option value="Morning (8 AM to 12 PM)">Morning (8 AM to 12 PM)</option>
<option value="Afternoon (1 PM to 4 PM)">Afternoon (1 PM to 4 PM)</option>
<option value="Evening (5 PM to 9 PM)">Evening (5 PM to 9 PM)</option>
</select>
</div>
</div>
</div>
<div class="row">
<div class="col-lg-12">
<div class="form-group">
<textarea type="text" class="form-control" id="message" name="message" placeholder="Message" required=""></textarea>
</div>
</div>
</div>
<div class="row">
<div class="col-lg-12">
<div class="form-group">
<span style="color: #ff0000;">Note:</span> The confirmation of appointment will be confirmed by our backend team and it is subject to availability of doctors or time slot.
</div>
</div>
</div>
</div>
<div class="modal-footer appointload">
<button type="button" class="btn btn-default" data-dismiss="modal">Cancel</button>
<button type="submit" class="btn btn-primary newsbtnew">Submit</button>
</div>
<div class="modal-footer appointloading" style="display: none"> Submitting the form Please wait...</div>
</div>
<div class="sucess_msg_bp hide"></div>
<div class="error_msg_bp hide"></div>
</form>
Name: bookapp — POST #
<form onsubmit="return false" novalidate="novalidate" action="#" method="post" enctype="multipart/form-data" name="bookapp" id="bookapp3" role="form">
<div class="app_form show">
<div class="modal-footer appointloading" style="display: none"> Submitting the form Please wait...</div>
</div>
<div class="sucess_msg_bp hide"></div>
<div class="error_msg_bp hide"></div>
</form>
Name: samplecollection — POST https://www.apolloclinic.com/crm/crm-integ.php
<form action="https://www.apolloclinic.com/crm/crm-integ.php" method="post" enctype="multipart/form-data" name="samplecollection">
<input type="hidden" class="form-control" name="utm_source" value="SEO">
<input type="hidden" class="form-control" name="utm_campaign" value="Home Sample Collection">
<div class="sample_collection show">
<div class="modal-body">
<div class="row">
<div class="col-lg-12">
<div class="form-group">
<label for="fullname">Full Name <strong style="color: #F00">*</strong></label>
<input type="text" class="form-control" id="cfullname" name="cfullname" placeholder="Full name" required="">
</div>
</div>
</div>
<div class="row">
<div class="col-lg-12">
<div class="form-group">
<label for="cemail">Email <strong style="color: #F00">*</strong></label>
<input type="email" class="form-control" id="cemail" name="cemail" placeholder="Email Address" required="">
</div>
</div>
</div>
<div class="row">
<div class="col-lg-12">
<div class="form-group">
<label for="cmobile">Mobile <strong style="color: #F00">*</strong></label>
<input type="text" class="form-control" id="cmobile" name="cmobile" placeholder="Mobile" required="">
</div>
</div>
</div>
<div class="row">
<div class="col-lg-12">
<div class="form-group">
<label for="cmobile">Enter Test Name <strong style="color: #F00">*</strong></label> <input type="text" class="form-control" id="ctests" name="ctests" placeholder="Tests" required="">
</div>
</div>
</div>
<div class="row">
<div class="col-lg-12">
<div class="form-group">
<label for="address">Enter City Name <strong style="color: #F00">*</strong></label>
<input type="text" class="form-control" id="caddress" name="caddress" placeholder="City" required="">
</div>
</div>
</div>
</div>
<div class="modal-footer samplefrmload">
<input type="submit" class="btn btn-primary" value="Submit">
</div>
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Contact information: Name, Address, Contact details, Email ID, Phone Number; b. Demographic information: Gender, Age, Date of Birth, Marital Status, Nationality; c. Other information that I provide to AHLL or is generated while availing services or interacting with AHLL employees, doctors, technicians, consultants, etc.; d. Health information such as my medical records and history provided by me or generated by AHLL in the course of my availing of any services from AHLL; e. Information about my insurance coverage provided by me or generated on availing any services from AHLL; f. Information regarding my physical, physiological and mental health provided by me or generated on availing any services from AHLL, etc.; g. Financial information (payment/billing information) that I provide for availing services from AHLL; and h. Any other information relating to the above which I may have shared with AHLL prior to the date of this consent form for availing any services. 2. Purpose of Collection: I understand that AHLL may use the information mentioned above to provide me with services, or use it for other purposes, some of which are below: a. Registration to receive services, maintenance of my unified health profile/records, identification, communication, information on new services and offers, taking feedback, help and complaint resolution, other customer care related activities or issues relating to the use of my services; b. Creation and maintenance of electronic health records for use by AHLL, Apollo group companies and affiliates, to provide relevant services; c. Receiving personalized announcements/offers of various Apollo group companies; d. Customising suggestions for appropriate medical products and services offered by AHLL and affiliates; e. Research for the development and improvement of our products and services including our diagnostics and treatment protocols; f. Disclosure as required to government authorities in compliance with applicable law; g. Investigating, and resolving any disputes or grievances; and h. Any purpose(s) required by applicable law. DISCLOSURE AND TRANSFER OF PERSONAL INFORMATION 3. For the abovementioned purposes, and to the extent permitted by applicable law, AHLL may share, disclose and in some cases transfer all or any information referred to above, to such entities as required to provide services to me, or for compliance with applicable laws. I understand that these entities include but are not restricted to Apollo group companies, affiliate companies, AHLL doctors, hospitals, diagnostic centres, chemists, third party service providers to AHLL, and law enforcement agencies. For these purposes, I consent to AHLL transferring my personal information to entities that may be located outside India. 4. 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I understand that I have the right to access my personal information, and request updation, correction and deletion of such information, but not information processed in de-identified form, or any information which is retained by AHLL to comply with applicable law. 8. I understand that I am free to not share any health, financial or other information that I deem confidential. I understand that I may withdraw consent for AHLL to use data that I have already provided to it. I understand that if I exercise these rights, AHLL can limit or deny the provision of services for which it considers such information necessary. 9. I understand that I may contact cs@apollohl.com for any questions or for exercise of these rights and for any other grievances related to my personal information. I hereby give my consent to AHLL to collect, use, store, share, and / or otherwise process my personal information in accordance with this consent form. Close × You visited Apollo Clinic services. 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