This privacy policy explains how personal data submitted through this appointment request form is processed.
1. Data Controller
The person responsible for processing the personal data submitted through this form is:
Justin Balmer
Dental Medicine Student
Email: justin.balmer2901@icloud.com
2. Personal Data Collected
This form may collect the following information:
Full name
Email address
Telephone number
Preferred appointment dates
Type of dental treatment you are interested in, if selected
3. Purpose and Legal Basis
Your personal data is collected solely for the purpose of receiving, processing and arranging your appointment request and contacting you regarding that request.
The processing is based on Article 6(1)(b) GDPR, as it is necessary to take steps at your request in connection with arranging the requested dental treatment.
4. Health Information
Please do not provide medical records, diagnoses, information about medical conditions, medications or other health information through this form.
Any medical or health information required in connection with treatment will be discussed separately in the appropriate clinical setting.
5. Use of Tally
This form is provided through Tally (Tally BV), which processes form submissions on behalf of the form creator.
Tally states that form data is encrypted in transit and at rest and stored in Europe. Tally acts as a data processor for data collected through forms.
Tally's GDPR information
6. Data Retention
Your personal data will only be retained for as long as necessary to process and arrange your appointment request. It will be deleted when it is no longer required for this purpose, unless retention is required by applicable law.
7. Your Rights
Under the General Data Protection Regulation (GDPR), you have the right, where applicable, to:
request access to your personal data;
request correction of inaccurate personal data;
request deletion of your personal data;
request restriction of processing;
object to processing; and
request data portability.
You also have the right to lodge a complaint with the competent data protection supervisory authority.
For questions regarding your personal data or to exercise your rights, please contact:
Justin Balmer
Email: justin.balmer2901@icloud.com
8. Appointment Requests
Submitting this form constitutes an appointment request only and does not confirm an appointment. You will be contacted separately to arrange and confirm a suitable appointment.
