Internal Regulations of the Medical Clinic

1 Establishment Identification

2 Purpose and Scope

The Dr. Joana Menezes Medical Clinic, hereinafter referred to as the "Clinic", is a private limited company with registered office at Travessa Armando Alves Tavares, n.º 139, parish of Ramalde, municipality of Porto (postcode 4100-010), and its purpose is to provide healthcare services in the areas of Endocrinology and Nutrition, Cardiovascular Risk, Internal Medicine, Pulmonology, Cardiology, General and Family Medicine, Psychology, Psychiatry, Child and Adolescent Psychiatry, Andrology, Sexual Medicine, Hormonal Consultation for Menopause / Peri-menopause, Nursing, Exercise Physiology, Nutrition, Stress Management and Mindfulness, Sociodrama, Hypnosis, Psychological Astrology, and Health Promotion and Education — all medical specialties covered offer medical consultations only, with no invasive procedures.

The premises are used exclusively for non-invasive medical and technical consultation activities, on an outpatient basis and by prior appointment. No minimally invasive or invasive surgical procedures involving greater risk to patients are performed, and no area related to aesthetic medicine is covered.

The Clinic provides a clinical laboratory sample collection service, with all procedures handled by Germano de Sousa (billing, collection, transport, analysis and disposal of biological and non-biological waste). It also offers home-based sleep studies, carried out by Linde, with each study validated and signed by a technician subspecialised in Sleep Medicine and by a Pulmonologist subspecialised in Sleep, a member of the team. It also offers 12-lead electrocardiograms, with the report validated and signed by Cardiology. The Clinic is likewise prepared for retail sales of books, health and wellness products, and nutraceuticals.

The Clinic was designed to guarantee an environment of quality, comfort and safety for patients, healthcare professionals and technical staff alike, in compliance with all standards established by the Health Regulatory Authority (ERS) for licensing purposes, as well as all regulations applicable to companies operating in Portugal.

These regulations establish the operating standards, internal organisation and conduct rules of the Clinic, ensuring ethical, professional and humane care in compliance with applicable legislation and the deontological principles of medical practice. They are also intended to govern the general operation of the clinic/practice, both internally and in respect of relations with patients, and apply to all employees and collaborators, including those working under service provision agreements, except for provisions which, by their nature, do not apply.

3 Clinical Services Organisation

• Clinical Directorate: responsible for technical coordination and compliance with medical and legal standards. In the Clinical Director's absence, the Deputy Clinical Director automatically assumes her duties.
• Administration: responsible for administrative and financial management, including staffing, working schedules, the price list and compliance with Occupational Health and Safety regulations.
• Clinical Secretariat: responsible for patient reception, appointment scheduling and confirmation, diary and email management, and clinical record administration.
• Clinical Staff: specialist physicians registered with the Portuguese Medical Council and healthcare professionals duly accredited and registered with their respective Professional Councils / Technical Associations. Although coordinated by the Clinical Directorate, clinical practice remains the autonomous ethical and professional responsibility of each collaborator.
• Support Services: cleaning, maintenance and other support staff. Laboratory sample collection is handled by Germano de Sousa and home-based sleep studies by Linde.

• Assume deontological responsibility for the Clinic's activity.
• Coordinate the care provided to patients.
• Keep informed of ongoing medical plans.
• Approve the admission of medical and non-medical technical staff, on a permanent or temporary basis.
• Decide on the creation or discontinuation of services.
• Foster cooperation between physicians, healthcare professionals and administrative staff.
• Ensure adequate professional qualification for all functions performed.
• Oversee the organisation of the clinical filing system.
• Keep an up-to-date confidential record of all Clinic staff.
• Ensure the confidentiality of clinical records.
• Ensure patients' rights and duties are upheld.
• Approve and propose protocols with other entities as an aid to diagnosis or treatment.

• Assume responsibility for all administrative acts, in coordination with the Clinical Directorate.
• Ensure compliance with the law, these regulations and any internal directives.
• Draw up the staffing plan and set working schedules and pay scales.
• Ensure the timely payment of agreed remuneration to professionals.
• Post and make available the price list for medical procedures and complementary services.
• Manage staff and exercise disciplinary authority, in close collaboration with the Clinical Directorate.
• Decide on the hiring of new collaborators.
• Ensure compliance with Occupational Health and Safety, Training and Workplace Health regulations.

• Maintain good manners, presentation and personal hygiene at all times.
• Handle reception, scheduling and confirmation of appointments, caring for the well-being of patients and professionals.
• Respect patients' rights and accompany them from the waiting room to the consulting room.
• Assist the medical consultation whenever required, in coordination with and under the direction of the physician.
• Ensure the organisation, cleanliness, disinfection and proper functioning of the consulting room.
• Handle phone calls, diary management and email management.
• Store nutraceuticals, health and wellness products, books, IT equipment and office supplies.
• Receive, store and organise deliveries and materials needed for the Clinic's operation.
• Care for the proper conservation and use of assets entrusted for their work.
• Uphold the good name and image of the Clinic.

• Treat Management, the Clinical Directorate, colleagues, patients and suppliers with courtesy and loyalty.
• Follow Management's and the Clinical Directorate's instructions regarding work execution and discipline, in strict compliance with the profession's ethical and deontological principles.
• Remain loyal to the Clinic, neither competing with it nor disclosing its working methods.
• Care for the proper conservation and use of assets entrusted for their work.
• Strictly observe health, hygiene and workplace safety standards.
• Attend to their scheduled duties punctually and diligently.
• Prepare the patient's clinical history and record, in writing, the treatment and prescriptions provided.
• Provide patients with the greatest possible well-being, upholding their rights.
• Care for the conservation of the Clinic's infrastructure and IT equipment.
• Report to the Clinical Directorate any noteworthy occurrences, including complaints and disciplinary matters.
• Always act, both within and outside the premises, in the interest of the Clinic's good name and health promotion.

Cleaning of the Clinic is carried out by Lucileia Souza Melgaço de Oliveira, with the maintenance of hygiene across all rooms being a constant concern. In the event of absence or replacement, a specific accredited cleaning company will be contracted, as designated by Management/Administration.

Germano de Sousa is responsible for the entire sample collection process — from staffing to collection, processing and transport of samples, treatment of biological and non-biological waste, and billing, in accordance with their agreements.

Linde is responsible for the entire home-based sleep study process, with each study validated and signed by a Pulmonology technician and by a Pulmonologist subspecialised in Sleep Medicine.

The Clinic may have assistants, healthcare professionals or occupational therapists who support medical consultations, as decided according to the needs of each specialty.

The Clinic offers patients books, health and wellness products, and nutraceuticals for sale, always duly advised by a healthcare professional, with a price list available both in person and online. The management of maintenance and other support staff is handled case by case by Management and Administration.

4 Opening Hours and Working Process

The Clinic may close, or bring forward its closing time, whenever the Clinical Directorate and Management so determine, for reasons such as holidays, courses, conferences, training, business reorganisation, maintenance works, clinical staff schedules or unforeseen circumstances. Fixed schedules may apply to specific specialties. Temporary changes to opening hours are announced on the official website and posted at reception.

Remote consultations are intended for clinical reports and information, renewal of therapeutic prescriptions and review of test results, whenever the physician so decides and considers it safe, without breaching deontological principles or medical bioethics. Consultations, assessments and sample collections may be carried out at the patient's home in situations determined by the Clinic's Directorate.

• Booking: in person or by phone/email, handled by the secretariat, with all necessary patient details requested in advance of the consultation.
• Reception: on the day of the consultation, the patient is welcomed by the secretariat and waits in a dedicated area offering comfort, hygiene and safety.
• Nursing/assistant assessment: before entering the consulting room, the patient completes relevant clinical information and is assessed by a Nurse, Assistant or Healthcare Professional.
• Consulting Room: full consultation — clinical history, physical examination, request for complementary tests and treatment plan, whenever all the necessary information has been gathered.

5 Appointment Booking and Cancellation

• Appointments may be booked in person, by phone or by email through the contacts available on the official website.
• Patients are asked to arrive 20 minutes before their scheduled appointment time.
• In cases of repeated unjustified absences that interfere with the proposed diagnostic and/or therapeutic process, the professional or the Clinic's Directorate may refuse further bookings and suggest referral to an equivalent service.
• If the patient arrives late, the healthcare professional will honour only the pre-established duration of the clinical appointment, with no compensation of time; whether the consultation takes place will depend on the professional's schedule and subsequent bookings.
• If a healthcare professional is late, the patient may leave without penalty or reschedule at no cost, at the earliest opportunity.
• If the Clinic cancels an appointment, a new booking will be arranged according to the availability of both the professional and the patient, as soon as possible.
• All bookings and cancellations must be made through the Clinic's secretariat.

6 Patients

Admission to the Clinic is only permitted after completion of an administrative form (name, date of birth, address, phone/email, citizen card number, tax number, health service user number, health subsystem and beneficiary number), and presentation of photographic identification may be required. Before the first consultation, reading and signing the GDPR consent form and the patient identification sheet is mandatory; refusal prevents any further follow-up at the Clinic. Patients will always be asked whether they consent to the sharing of their data for clinical and scientific research purposes, with their identity kept anonymous at all times.

• Respect the rights of other patients, healthcare professionals and Clinic staff.
• Respect the Clinic's organisational and operational rules.
• Cooperate with healthcare professionals on all aspects of their care.
• Provide truthful, complete and up-to-date information about their health status — withholding information is solely and exclusively the patient's responsibility.
• Inform the Clinic of any new circumstances that may interfere with their treatment or health.
• Arrive punctually for scheduled appointments, observing the requested arrival time.
• Behave with courtesy, respecting the Clinical Staff, Management and the Clinical Directorate.
• Comply with internal safety, hygiene and etiquette standards within the clinical space.

• The secretariat handles administrative matters only (bookings and payments) for services provided on the Clinic's premises; clinical questions must be addressed to healthcare professionals during the scheduled consultation.
• The patient, the legal guardian (in the case of a minor) or the appointed guardian (in the case of a supported adult) must inform the Clinic's Directorate of any physical or psychological health conditions that may pose a risk to other patients or staff, with the confidentiality of this information guaranteed.
• In the event of an accident occurring on the premises, transfer to the nearest hospital will be arranged when necessary, activating the insurance to which the patient is entitled.
• The administration of any medication on the Clinic's premises is the responsibility of the physician concerned, following due explanation to the patient and the signing of a consent and liability form.
• The Clinic accepts no responsibility for patients' valuables or personal belongings. In the case of a minor or dependent adult, safekeeping of personal items may be requested while services are provided.
• The Clinic sends prescriptions, test requests, invoices and/or reports by post only in extraordinary exceptional circumstances decided by the Directorate, and exclusively to patients residing outside the District of Porto.
• Acceptance of and compliance with these regulations is binding on patients of legal age, on the legal guardian in the case of a minor, or on the appointed guardian in the case of an incapacitated or supported adult, with no signature required.

7 Confidentiality, Professional Conduct and Ethics

Physicians are bound by professional secrecy regarding all patient-related information, whether or not recorded in the clinical file, obtained in the exercise of their profession. Physicians' staff and all those who collaborate with them are equally bound by secrecy, with the physician bearing deontological responsibility for its observance.

The physician may provide information to the patient or to a third party appointed by the patient, and may require a written declaration from the patient granting that third party the authority to act on their behalf. Any disclosure of matters subject to professional secrecy requires prior authorisation from the Portuguese Medical Council; disclosure for academic, scientific and professional purposes is not considered a breach, provided the patient's identity is not indicated. Statements made by a physician in breach of professional secrecy are inadmissible as evidence, whether in court or elsewhere.

Clinical records are confidential, and their storage and safekeeping are managed through the Clinic's medical software (iMed, by the ACIN group). All professionals adhere to the ethical and legal principles of medicine and the Codes of Conduct of their respective Professional Councils. Discriminatory practices or disrespectful treatment of patients or colleagues are strictly prohibited. All medical acts are recorded in the patient's clinical file, and professionals are subject to internal and external audits to verify the quality of service.

8 Hygiene, Safety and Infection Control

• Rigorous hygiene protocols: cleaning of the premises, surface disinfection and sterilisation of clinical materials.
• Infection prevention protocols, use of personal protective equipment and frequent handwashing.
• Emergency and first aid plans in place, with regular team training.
• Active self-protection measures plan.
• Accessible premises for people with reduced mobility, in compliance with current safety standards.

9 Payments, Price List and Insurance

Medical services are charged according to the price list in force, available at the Clinic's reception, which may be updated at Management's discretion.

10 Complaints, Suggestions and Conflict Resolution

11 Final Provisions

These regulations may be amended by resolution. Matters not covered herein will be resolved by Management and/or the Clinical Director, according to their nature, in keeping with the spirit of these regulations and in compliance with the law.

The updated version is available at the Clinic's reception and at www.joanamenezes.com or www.joanamenezes.pt.