Ubreak Free

For doctors and mental-health professionals

Specialist consent form

Please read the terms below, enter your details and tick to agree. We will email a six-digit code from Ubreak Free to the address you give. Entering the code is your signature, and we email you a copy of the signed record.

Terms of listing

1. Listing. I agree to be listed as a specialist on Ubreak Free (ubreakfree.org) after the Ubreak Free team has verified my credentials. Ubreak Free may decline or remove a listing.

2. Accuracy. The qualifications, registration number and details I have given are true and current. I will tell Ubreak Free promptly if they change.

3. Professional conduct. I will treat every patient with respect and without judgement, work within my competence and registration, keep my own clinical records and use my own clinical judgement. Ubreak Free does not make clinical decisions.

4. Confidentiality. I will keep patient information confidential, use it only for the patient's care, and follow applicable Indian law, including the Digital Personal Data Protection Act, 2023 and the applicable telemedicine guidelines.

5. Contact. Ubreak Free may email me at the address verified here about appointments, onboarding and platform matters. I may withdraw consent at any time by writing to contact@ubreakfree.org.

6. Signature. Ticking the boxes and entering the code sent to my email is my electronic signature. Ubreak Free may keep the time, IP address and browser details of this signing as evidence.

Your details

Agreement