PERSONAL DATA PROCESSING INFORMATION AND CONSENT DECLARATION FORM
I, the undersigned (Data Subject), hereby declare that I have been informed about the acts of collection, processing, and storage of my data and that I provide, in accordance with the provisions of Articles 7 and 9 of the General Data Protection Regulation (GDPR / (EU) No. 679/2016, as well as the relevant applicable provisions transposing it into national legislation), my explicit consent to the Company under the trade name COSMETIC DERMA MEDICINE IATRIKI SA, TIN EL 800412186, with registered office KONSTANTINOU VENTIRI 5 ‐ ILISIA, P.C. 11528, ATHENS and I accept that my personal data be collected, processed, and stored for the purposes cited below.
Data shall be mainly processed for Medical Record Keeping, in accordance with Article 14 of the Code of Medical Ethics. This shall include in particular:
The data to be processed by the Company fall within the following categories:
My data may be transmitted to:
The Company shall collect, store and, in general, process my data for a period of twenty (20) years at the latest from my last visit to the clinic.
I have been advised that I have the right to withdraw my present consent at any time, as well as of the consequences of such withdrawal. In particular, I have been informed that, in case of withdrawal of my consent for processing of data that are absolutely necessary for the provision of the treatment requested, then such provision shall not be possible.
Moreover, I have been informed about my rights cited below, as applicable under the conditions laid down in the General Data Protection Regulation (GDPR / (EU) No. 679/2016), as well as the relevant applicable provisions transposing it into national legislation. More specifically:
Exercise of the above‐mentioned rights shall be conditional on the submission of a written application to the Company, free of charge, at the email address dpo@cosmeticdermamedicine.gr. For any matter whatsoever, I can contact the Personal Data Protection Officer of the Company, by sending an email at dpo@cosmeticdermamedicine.gr. In any case, I am entitled to contact the Personal Data Protection Authority either by mail (1‐3 Kifissias Ave., PC 115 23) or by e‐mail (www.dpa.gr).
If the relevant consent is not granted or is withdrawn, in whole or in part, the Company shall maintain the right to refuse and/or terminate the provision of any service, even plain information provision. Moreover, the Company shall maintain the right to keep records for reasons of protecting its legal rights and providing evidence before any judicial or administrative authority.
In case of exercise of any of the above‐mentioned rights, the Company shall take all reasonable measures to satisfy the relevant request within thirty (30) calendar days from receiving it, by notifying the person concerned in writing of its satisfaction, or of the reasons preventing such exercise.
I have been explicitly informed that the Company will collect, store, and process my data for implementing targeted marketing activities, or for sending company newsletters, or for the commercial promotion of products of the Company or of other companies of the same Group, or for purposes of surveys related to the quality of the services it provides.
For the above purpose, my data may be transmitted to associated companies that carry out surveys or implement promotional activities.
Within the context of the same processing, I have been advised of my right to object to such processing at any time, by sending a relevant request to the Company (email: dpo@cosmeticdermamedicine.gr).
The Company has adopted a policy consistent with the Personal Data Protection Law, which gives you the right to control in the future the use of photographs or videos of you taken during your treatment.
Taking into account the explanations provided by the Company:
I have been advised of the above processing of my personal data and I CONSENT to it, as specifically laid down in this document.
For the Company
Personal Data Protection Department e‐mail: dpo@cosmeticdermamedicine.gr.