GDPR Consent Form

GDPR Consent form for patients, former patients and prospective patients

Your privacy is important to us, and we want to communicate with our patients in a way which has
their consent, and which is in line with UK law on data protection including the General Data
Protection Regulation (GDPR). Please see our Privacy Notice which is available from our website at
www.healthpointclinic.co.uk or on request.

Our Privacy Notice and this consent form refer to personal data. Personal data means any
information relating to an identified or identifiable natural person (‘data subject’); an identifiable
natural person is one who can be identified, directly or indirectly, in particular by reference to an
identifier such as a name, an identification number, location data, an online identifier or to one or
more factors specific to the physical, physiological, genetic, mental, economic, cultural or social
identity of that natural person. Personal data includes your name, address, email address and phone
number.

Our Privacy Notice and consent form also refer to processing. Processing means any operation or set
of operations which is performed on personal data or on sets of personal data, whether or not by
automated means such as collection, recording, organisation, structuring, storage, adaption or
alteration, retrieval, consultation, use, disclosure by transmission, dissemination or otherwise
making available, alignment or combination, restriction, erasure or destruction. Processing includes
using your contact details to send you our newsletter or other marketing materials.

As a result of a change in UK law, we now need your consent to how we contact you. Please fill in
the contact details you want us to use to communicate with you:


By signing this form you are confirming that you are consenting to LC Clinic holding and processing
your personal data for the following purposes (please tick the boxes where you grant consent) :- I
consent to LC Clinic contacting me by:


Receive Updates

To keep me informed about news, events, activities and special offers at LC CLinic.

Where you do not grant consent we will not be able to use your personal data for marketing
purposes (so for example, we may not be able to let you know about open days or special offers).
We will still be able to use your personal data for: yours or our legitimate interests in connection
with the provision of health care services to you; or if necessary in compliance with a legal obligation
which our practice/clinic is subject to. These lawful uses of your personal data not requiring your
consent are set out in our Privacy Notice.

You can withdraw or change your consent at any time by contacting LC Clinic, Augres Associates,
Suite 2.9, Lido Medical Centre, St Saviours Road, JE2 7LA or at info@lidochiroclinic.co.uk. Please note
that all processing of your personal data for marketing purposes will cease once you have withdrawn
consent but this will not affect any personal data that has already been processed prior to this point.
All other lawful processing of your personal data because it is in yours or our legitimate interests in
connection with the provision of health care services to you; or it is necessary in compliance with a
legal obligation which our practice/clinic is subject to – may continue.


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