INFORMATION ABOUT TO THE PROCESSING OF PERSONAL DATA
Pursuant to art. 13 act. 1 and 2 and art. 14 act 1 and 2 of Regulations of the European Parliament and of the Council (EU) 2016/679 from 27th April 2016 on the protection of natural persons with regard to the processing of personal data and on the free movement of such data, and repealing Directive 95/46/EC (General Data Protection Regulation).
- the Administrator of my personal data shall be the Non-public Healthcare Villa Nova Dental Kiworkowa Spółka Partnerska Lekarzy Stomatologów with the registered office in Warsaw, holding the KRS number 0000252233, taxpayer identification number NIP 9512173139 and the statistical number REGON 140456786;
- the Data Administrator has designated Data Protection Officer, who may be contacted via email: iod@villanova.pl;
- personal data will be processed on the basis of my consent (Article 6 (1) (a) of the GDPR) in order to perform an oral or written contract for the provision of medical services offered by the administrator to which I am a party to (Article 6 (1) (b) of the GDPR ) and in connection with the implementation of the legal obligation incumbent upon the administrator (Article 6 (1) (c) of the GDPR);
- the recipient of my personal data will be entities authorized to receive them on the basis of applicable law (the Tax Office, the Social Insurance Institution, entities listed in the provisions of the Act of November 6, 2008 on patient’s rights and the Patient Ombudsman (i.e. Journal of Laws of 2020, item 849, as amended) and entities acting for the data administrator, i.e. entities providing services: legal, IT, health and safety, archiving – on the basis of entrustment agreements concluded with these entities;
- my data will be stored for the purpose for which it was collected, and then for the purposes of possible redress, until the statute of limitations, including for the period resulting from the provisions of the Act of November 6, 2008 on patient rights and the Patient Ombudsman (Journal of Laws of 2020. pos. 849, as amended) and the implementing regulations issued on the basis of their wording each time, in particular the provisions of the Regulation of the Minister of Health of 6 April 2020 on the types, scope and templates of medical documentation and the method of its processing (Journal of Lawsitem 666);
- I have the right to access my data and the right to request rectification, deletion or limitation of processing in the cases specified in art. 18 of the GDPR, or to object to the processing (with the exception of data processing pursuant to Article 6 (1) (c) of the GDPR), as well as the right to data portability. These rights may be excluded or limited if the Administrator will demonstrate that the grounds for processing my data by them results from the implementation of tasks specified in generally applicable regulations, or that the foundation for data processing override my rights, or that these data are necessary to establish, assert or defend claims;
- I have the right to withdraw my consent, with then all activities performed before the consent withdrawal remaining valid; after the consent is withdrawn, the provision of medical services will not be possible;
- I have the right to lodge a complaint to the President of the Office for Personal Data Protection, when I decide that my personal data violates the rules of GDPR;
- providing personal data results from the contract concluded with the Administrator, the consequence of not providing personal data will be the inability to implement thiscontract;
- my data will be processed automatically in dedicated financial and accounting software.
In addition, I have been informed that the Data Administrator is also bound by the provisions on the processing of personal data contained in the Act of November 6, 2008 on the rights of patients and the Patient Ombudsman (Journal of Laws of 2020, item 849, as amended) and implementing acts issued on its basis in their respective wording, in particular the provisions of the Regulation of the Minister of Health of April 6, 2020 on the types, scope and templates of medical documentation and the method of its processing (Journal of Laws, item 666). Pursuant to the provisions of the Act, the data necessary to keep medical records referred to in Art. 25 cannot be deleted.
Date and legible signature of the patient or legal guardian
In case of questions regarding the processing of personal data, pleasec ontact the Personal Data Inspector by mail at the following address: NZOZ “VILLA NOVA DENTAL CLINIC” Kiworkowa Spółka Partnerska Lekarzy Stomatologów ul. Przyczółkowa 219, 02-962 Warszawa, with a note mentioning Data Protection Officer and by e-mail: iod@villanova.pl
Based on the concluded cooperation agreement, this information clause also applies to the personal data processing by:
1. Villa Nova Orthodontics by Kiworkowa & Brandt Sp. z o.o.
Address: Przyczółkowa 219, 02-962 Warsaw, NIP: 951-256-34-90, KRS: 0001022955
2. Kiworkowa Dental Clinic, Sp. Jawna
Adress: Przyczółkowa 219, 02-962 Warsaw, NIP: 527- 268-67-41, REGON: 146404945, KRS: 0000440801