The user agrees that this form is solely for the renewal of prescriptions previously prescribed by Dr. Muñoz and therefore no medical consultations or new treatments are provided.
The user agrees that his or her medical history may be consulted to confirm the information.
Data Protection Law
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DERMATOGOG SL
Explicit consent for data processing to send communications, data, and images for clinical purposes (PATIENTS)
DERMATOGOG SL is the Controller of the personal data of the Interested Party and informs you that these data will be processed in accordance with the provisions of Organic Law 3/2018, of December 5, on the protection of personal data and guarantee of digital rights and in Regulation (EU) 2016/679 of April 27, 2016 (GDPR), for which the following processing information is provided:
(1) Purpose of processing: By consent of the data subject [GDPR ART. 6.1] for the following purposes: The provision of medical services and maintenance of the data subject's clinical history, and the recording of images and audiovisual material of patients for monitoring and analysis within the medical team and with exclusive access by healthcare professionals.
(2) Data retention criteria: Data will be retained for no longer than necessary to maintain the purpose of the processing. When no longer required for that purpose, data will be deleted using appropriate security measures to ensure pseudonymization of the data or its complete destruction. Your medical history and billing information will be retained for the established legal periods. Contact information will be retained as long as you do not request your right to erasure or unsubscribe.
(3) Legitimation: Legitimation is the fulfillment of legal obligations and the consent granted.
(4) Recipients: Your data may be transferred to Health Departments and Public Administrations when required by law; as well as to banks and savings banks if you make payments by card. We undertake not to transfer your data to any other company, entity, or natural or legal person, unless such transfer is made by legal requirement.
(5) International transfers: Not made.
(6) Confidentiality: The personal data you provide us will be treated confidentially. Our staff has previously committed to the duty of secrecy. Technical and organizational measures have been implemented to limit access exclusively to authorized persons. (7) Minors: If the patient is under 14 years of age, their legal representative or holder of parental authority or guardianship must authorize it. Please note that we may ask for your NIF (Tax Identification Number) or identity document to verify your age, as well as documentation to prove the reason for representation when appropriate. (8) Rights: You may exercise your rights of access, rectification, deletion, restriction, portability and opposition over your personal data, by requesting it in writing at the Clinic, enclosing a copy of your identity document. We have templates available for you to exercise your rights. If you consider your rights have been violated, you can file a complaint at www.aepd.es .
If you would like more information about our data protection policy, please contact us ( secretaría@capilderm.com ).
I authorize the processing of my personal data for the purposes indicated
