SARS-Cov-2 genetic tests with J.P. Morgan

Dear Sir or Madam,
if you want to perform a genetic test - SARS-Cov-2 RNA qualitative (PCR) in cooperation with J.P. Morgan please provide the following details:

Personal data

Name *

Surname *

Date of birth *

PESEL number *

Address

Street *

House number *

Flat number

Postcode *

City*

Contact details

Telephone number *

Select the city where you want to do the test

Select the city where you want to do the test *

Details of the referring doctor

Name *

Surname *

Choose the date of the test

Basic information on the processing of personal data for marketing purposes

Data Controller Centrum Medyczne Damiana Holding Sp. z o.o., ul. Wałbrzyska 46, 02-739 Warsaw
Purposes of processing To provide you with medical services; conclude a contract for the provision of services, provide you with other types of services, including cosmetology services, manage the services we provide, settle business transactions, handle complaints, opinions and requests, send you materials promoting products and services, including using profiling, archive your data in accordance with the law, pursue and defend against claims; ensure the safety of persons and property, in particular through video surveillance, implement requests regarding your rights under the GDPR; conduct quality and satisfaction surveys (also based on profiling);
Legal basis for processing Provision of medical services, contract execution, your consent, our legitimate interest; legal obligation, public interest
Data recipients Entities processing personal data for the data controller, entities authorised by law, entities authorised by you
Rights related to data processing
- the right to object to data processing for marketing purposes,
- the right to object to data processing due to a special situation,
- the right to transfer data,
- other rights referred to in the detailed information on data processing

Declaration of consent to marketing contact via voice messagesI agree to receive from Centrum Medyczne Damiana Holding Sp. z o.o., ul. Wałbrzyska 46, 02-739 Warsaw and Medicover Polska entities, commercial and marketing information via telecommunication end devices and automated calling systems in the form of voice communication (telephone conversation, IVR voice messages)

Declaration of consent to marketing contact via electronic messagesI agree to receive from Centrum Medyczne Damiana Holding Sp. z o.o., ul. Wałbrzyska 46, 02-739 Warsaw and Medicover Polska entities, commercial and marketing information via telecommunication end devices and automated calling systems in the form of electronic messages (e-mail, SMS/MMS, websites, including social networks, push notifications)

Declaration of consent to the processing of data for the marketing of Medicover Polska products and servicesI consent to the processing of the personal data provided by me by Centrum Medyczne Damiana Holding Sp. z o.o. ul. Wałbrzyska 46, 02-739 Warsaw for the purpose of marketing the products and services of Medicover Polska entities, including by profiling/sending marketing materials.

* required field

On the next business day (Mon-Fri) Damian Medical Centre will inform you of the date, time and place of your scheduled test.