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Essential information and documents

Customer area

Essential information and documents

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Information clause

Please read the information clause concerning the protection of personal data of our patients:

  1. The administrator of your personal data is Stomatologia Rodzinna Jacek Łupicki based in Stalowa Wola(37-450) Al. Jana Pawła II 15D, NIP: 8651409036, tel. 15 842 40 85.

  2. The legal basis for the processing of your data in the field of medical activities, including keeping medical records, is art. 6 (1) (a) c of Regulation (EU) 2016/679 of the European Parliament and of the Council of 27/04/2016 on the protection of individuals with regard to the processing of personal data and on the free movement of such data, and repealing Directive 95/46 / EC (hereinafter GDPR) in connection with with the provisions of the act of April 15, 2011 on medical activity and the act of November 6, 2008. on the rights of the patient and the Patient’s Rights Ombudsman. The basis for data processing to the extent necessary to protect the vital interests of the patient may also be Article 6 (1) (d) of the GDPR. To the extent that the processed data includes data of special categories, the legal basis for data processing is Article 9 (2) (a) of the GDPR. c and h GDPR.

  3. Your data are processed for the purpose of health care, provision of medical services, management of the provision of these services and treatment. Providing them is voluntary, however, failure to provide them will result in the inability to provide medical services.

  4. Your personal data are processed only to the extent related to the fulfillment of the above purposes. We do not share your data with any other recipients except entities processing data on our behalf participating in the fulfillment of the purpose described in point 2, or participating in the performance of legal obligations incumbent on us, and entities authorized by law.

  5. The administrator does not intend to transfer your data to a third country or international organization.

  6. Your data will be stored for no longer than necessary, i.e. for the period specified by the relevant law: the Act of November 6, 2008 on Patients’ Rights and Patients’ Rights Spokesman.

  7. You have the right to request from the Administrator access to your data, rectification, updating, as well as the right to restrict data processing. The rules for providing access to medical records are defined by the provisions of Polish law.

  8. In connection with the processing of your personal data by the Administrator, you have the right to lodge a complaint with the supervisory authority.

  9. Providing us with your personal data is a statutory requirement, it applies to each Patient in respect of whom we carry out the purposes described in Section 2.

  10. Based on your personal data, the Administrator will not make automated decisions against you, including decisions resulting from profiling*.

* Profiling means any form of automated processing of personal data that involves the use of personal data to evaluate certain personal factors of an individual, in particular to analyze or forecast aspects of that individual’s work, economic situation, health, personal preferences, interests, reliability, behavior, location or movement.

Patient documentation

In accordance with applicable laws, the patient has the right to access medical records relating to his or her condition and the health services provided.

Medical records are made available:

  • directly to the patient to whom the documentation pertains,
  • to his legal representative (e.g., parents of a minor patient),
  • another person authorized by the patient.

Application for medical records download application.

The first copy of medical records to the extent requested shall be made available to the patient or his legal representative free of charge. This applies to any form of making medical records available. The Clinic charges a fee for making the same documents available again.

Maximum fee for providing medical records:

  • one page of an extract or a copy of medical records – may not exceed about 8 zł 44 gr*
  • one page copy or printout of medical records – may not exceed about 30 gr**
  • providing access to medical records on a computer data carrier – may not exceed about 1 zł 69 gr***

* 0,002
** 0,00007
*** 0,0004

– average salary in the previous quarter, announced by the President of the Central Statistical Office in the Official Journal of the Republic of Poland „Monitor Polski” pursuant to Article 20(2) of the Act of December 17, 1998 on pensions from the Social Insurance Fund (Journal of Laws of 2016, item 887, as amended), starting from the first day of the month following the month in which the announcement was made.

Legal Basis : Act of November 6, 2008 on Patients’ Rights and Patients’ Ombudsman (Journal of Laws of 2016, item 186, as amended).

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