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患者信息
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| 性别 |
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| 可以联系到你的方式 * |
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请添加你认为在我们联系你之前应知的关于想要求助的医疗问题或诊断的信息，以便最好地处理你的请求。 |
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| 个人资料处理同意书 |
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With reference to Legislative Decree n. 196/03, art. 13 (Law about personal data protection), we hereby inform you that your consent to the treatment of your personal data is required to allow you sending the filled referral form. Your personal data will be filed in our archives and processed both by paper and electronic format, in compliance with all the security and confidentially measures fixed by Law, Exhibit B. Your personal data may be transmitted to third party that should carry on all the necessary activities to manage your request. We inform you that the Data Controller is “GVM Care & Research S.p.a.”, with legal office in Lugo, Via Garibaldi n. 11 . We also specify that art. 7 of the Law attributes specific rights to citizens. In particular, you may obtain the access to your data or obtain their updating, correction, integration, deletion, the turning in anonymous form (if it is possible) or the blocking of any data treated in breach of the law. We should inform you that your refusal to authorize the use of your personal data will not allow us to carry out the requested services. |
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