Declaration of consent for the processing of personal data

Danish version below

By signing this declaration, I hereby consent to Sage Body and Mind Therapy and the data processors who Sage Body and Mind Therapy uses at any time, processing the following personal data about me.

Personal data that is collected and processed:

• Name and surname,
• E-mail address,
• Mobile phone number, 
• Health data

I consent to Sage Body and Mind Therapy contacting me via telephone, e-mail, and SMS, concerning a specific booking I have made for treatment.

Collection and processing of sensitive personal data

By signing this declaration of consent, I give my simultaneous consent to Sage Body and Mind Therapy storing and processing the following sensitive personal data in association with receiving healthcare treatment:

• What treatment is received
• What date the treatment is received
• Any physical problems and any injuries you have suffered
• What advice and what guidance is given

Our processing of your personal data takes place in accordance with Regulation (EU) 2016/679 of the European Parliament and of the Council of 27 April 2016 on the protection of natural persons with regard to the processing of personal data and on the free movement of such data as well as the repealing Directive 95/46/EC (General Data Protection Regulation).

Data is stored electronically with Terapeut Booking (www.terapeutbooking.dk).

This is how your personal data is processed
Your personal data is collected, processed, and stored electronically.

What are my rights?

• You have the right to be informed about collection/processing and transfer of your personal data, for use in electronic data processing.
• You have the right to access the information about you that Sage Body and Mind Therapy  has processed electronically.
• You have the right to object to your personal data being processed electronically.
• You have the right to demand the correction, deletion or limiting of collection of your personal data.

Storage of your personal data
The above mentioned "Personal data that is collected and processed" by Sage Body and Mind Therapy  will be stored for up to 12 months after final collection and processing of the data.

Data collected as a result of ticking "Receive SMS" and/or "Allow newsletters" will be stored for up to 12 months after your last use of treatment via Sage Body and Mind Therapy , or if you opt out newsletters.

The personal data collected by Sage Body and Mind Therapy ' health care providers is stored in accordance with Danish Executive Order no. 1090 of 28 July 2016 on Licensed Health Care Professionals' Patient Records (Bekendtgørelse nr. 1090 af 28. juli 2016 om autoriserede sundhedspersoners patientjournaler) for five years from the last note in the journal, cf. s. 15, paragraph 2 of the Danish Executive Order on Licensed Health Care Professionals' Patient Records.

Cancellation policy: 

You can cancel your appointment 24 hours in advance by logging in to your profile. When you do not show up for a scheduled appointment, you are taking an appointment slot that could have been used for another patient.  In case of late cancellation or a No-show you will be charged a missed appointment fee: a fixed amount of 500 DKK, or a fee corresponding to 70% of the missed appointment.

This consent may be revoked
You can always contact Sage Body and Mind Therapy  via e-mail: sigita.skudra@withtheview.com  and revoke your consent.

Acceptance and signature
By electronically signing this declaration of consent, I confirm that I:

• Agree that Sage Body and Mind Therapy , and data processors used by Sage Body and Mind Therapy  may process the said personal data concerning me,
• Have been informed that I can complain about the processing of my personal data to the Danish Data Protection Agency, Borgergade 28, 1300 Copenhagen, Denmark, tel. +45 33193200, or via the e-mail address: dt@datatilsynet.dk.
• Have been informed that signing this consent form is voluntary. Understand that if I do not sign this declaration of consent, I will not be able to receive health treatments through Sage Body and Mind Therapy .
• Have been informed that I may revoke my consent at any time.

Danish version

Samtykke til håndtering af personoplysninger

Behandling af dine personoplysninger – samtykke

Jeg giver hermed mit samtykke til at Sage Body and Mind Therapy må indsamle og behandle mine personoplysninger. Personoplysninger omfatter følgende typer:

• Navn
• E-mail adresse
• Kontaktinformation
• Helbredsoplysninger

Oplysningerne opbevares elektronisk hos Terapeut Booking (www.terapeutbooking.dk).

Jeg giver samtykke til, at Sage Body and Mind Therapy må kontakte mig via telefon, e-mail og SMS, hvis det omhandler en af mig foretaget specifik booking af behandling.

Indsamling og behandling af følsomme personoplysninger
Ved underskrift af denne samtykkeerklæring giver jeg samtidig samtykke til, at Sage Body and Mind Therapy i forbindelse med, at jeg modtager en sundhedsbehandling, indsamler og behandler følgende følsomme personoplysninger:

• Hvilken behandling der udføres
• Hvilken dato behandlingen udføres
• Hvilke gener og eventuelle skader du har
• Hvilke råd og hvilken vejledning som er givet

Vores behandling af dine personoplysninger sker i henhold til EUROPA-PARLAMENTETS OG RÅDETS FORORDNING (EU) 2016/679 af 27. april 2016 om beskyttelse af fysiske personer i forbindelse med behandling af personoplysninger og om fri udveksling af sådanne oplysninger og om ophævelse af direktiv 95/46/EF (Persondataforordningen).

Således behandles dine personoplysninger
Dine persondata indsamles, behandles og opbevares elektronisk.

Hvilke rettigheder har jeg?

• Du har ret til at blive orienteret om indsamling/behandling og videregivelse af dine personoplysninger til brug for elektronisk databehandling.
• Du har ret til at få indsigt i de oplysninger om dig, som Sage Body and Mind Therapy  behandler elektronisk.
• Du har ret til at gøre indsigelser mod, at dine personoplysninger behandles elektronisk.
• Du har ret til at kræve, at dine personoplysninger berigtiges, slettes eller begrænses.

Opbevaring af dine personoplysninger
De af ovenfor under ”Persondata, der indsamles og behandles” nævnte indhentede og behandlede personoplysninger opbevares indtil 12 måneder efter sidste indsamling og behandling af oplysningerne.

Oplysninger indsamlet via din afkrydsning i ”Modtag SMS” og/eller ”Tillad nyhedsbreve” opbevares indtil 12 måneder efter, din sidste benyttelse af behandling via Sage Body and Mind Therapy, eller du har frameldt dig nyhedsbreve.

De af Sage Body and Mind Therapys' sundhedsbehandlere indhentede personoplysninger opbevares i henhold til Journalbekendtgørelsen (bkg. nr. 1090 af 28. juli 2016 om 1090 om autoriserede sundhedspersoners patientjournaler) i fem år fra 5 år fra det seneste notat i journalen, jf. journalbekendtgørelsens § 15, stk. 2.

Journalføring

Af hensyn til patientsikkerheden er det nødvendigt, at der bliver ført en journal, når sundhedspersoner behandler patienter. Disse regler om autoriserede sundhedspersoners journalføringspligt findes i autorisationsloven kapitel 6, §§ 21 – 25.

Tilbagetrækning af dit samtykke til behandling af dine personoplysninger

Du kan altid trække dit samtykke tilbage. Dette kan du gøre ved at kontakte Sage Body and Mind Therapy på e-mail: sigita.skudra@withtheview.com

Cancellation policy: 

You can cancel your appointment 24 hours in advance by logging in to your profile. When you do not show up for a scheduled appointment, you are taking an appointment slot that could have been used for another patient.  

In case of late cancellation or a No-show you will be charged a missed appointment fee: a fixed amount of 500 DKK, or a fee corresponding to 70% of the missed appointment.

Accept og underskrift

Jeg bekræfter ved min elektroniske underskrift på denne erklæring, at jeg er:

• Indforstået med, at Sage Body and Mind Therapy og de af Sage Body and Mind Therapy  benyttede databehandlere behandler de nævnte personoplysninger om mig,
• Informeret om, at jeg kan klage over behandlingen af mine personoplysninger til Datatilsynet, Borgergade 28, 1300 København K, tlf. 33193200, eller via e-mail: dt@datatilsynet.dk.
• Oplyst om, at det er frivilligt at underskrive denne samtykkeerklæring. Hvis jeg ikke underskriver erklæringen, kan jeg blot ikke modtage sundhedsbehandlinger via Sage Body and Mind Therapy .
• Oplyst om, at jeg til enhver tid kan tilbagekalde mit samtykke.