according to Regulation (EU) 2016/679 of the European Parliament and of the Council of 27 April 2016 (“GDPR") and other relevant legal regulations (hereinafter referred to as "consent")
Consent is granted by the data subject (hereinafter "customer")
Name, surname, title ………………………………………………………
Birthdate ………………………………………………………………
Address ……………………………………………………………………………………
Telephone / email address ……………………………………………………
The declaration must be submitted before starting the procedure.
I declare that I respect the above instructions and that I do not suffer from any of the conditions and diseases listed below, which are contraindications to whirlpool baths, alternating foot showers, general aromatic or classical massages, sports massages, lava stone massages, honey massages, reflexology massages of the soles of the feet, underwater massages, cupping massages, Sigorol massages, paraffin wrap, peat compress, small peat wrap (i.e. for 2 places), instrumental lymphatic drainage of the lower limbs, cinnamon anti-cellulite wrap:
- acute infectious, febrile or other serious illness, general physical weakness
- severe vascular heart diseases, heart rhythm disorders, unstable high blood pressure (higher than 160/100), unstable angina pectoris, acute myocardial infarction, heart failure, I do not have an implanted pacemaker
- inflammations and other diseases of the skin and subcutaneous tissue, damage to the skin at the site of application, including fungal disease
- acute superficial vein inflammation (or up to 6 months after the inflammation) or deep vein thrombosis
- I do not have more extensive varices (vein communities), a leg ulcer or a condition after a leg ulcer
- I do not suffer from blood clotting disorders and I do not take so-called anticoagulants - blood-thinning drugs (e.g. Warfarin)
- I do not suffer from serious blood circulation disorders in the lower limbs
- serious neurological disease, especially with disorders of skin sensitivity
- I am not allergic to honey (in case of honey massage)
- I am not pregnant (in the case of female clients)
I further declare that if there were serious and fundamental changes in my state of health, I am obliged to communicate this fact.
Consent is informed, freely and voluntarily granted to the data controller (hereinafter "AL")
Alžbětiny Lázně, as, ID number: 26342421, VAT number: CZ26342421, with registered office at Smetanovy sady 1145/1, Karlovy Vary, 360 01, registered in the commercial register of the Regional Court in Pilsen, section B, insert 968, or legal successor
WHY, WHAT PERSONAL DATA AND HOW DO WE PROCESS ABOUT YOU?
Thanks to consent, you enable more effective mutual communication and AL To ensure your needs, they will be able to offer you products and services tailored to your needs and other advantages of the offered products. Current comprehensive information on the processing of personal data, lists of processors and a list of rights and obligations of the customer and AL, incl. instructions on the consequences of partial or complete non-granting of consent are published on the website www.spa5.cz and at the customer's request will be provided at the AL point of contact. The provision of services based on concluded contracts is not conditioned by this consent, and you can change your decision and withdraw consent at any time.
The customer agrees to the processing of his following personal data by AL, as well as by its employees and contractual processors with whom AL has a personal data processing agreement, if this is necessary to fulfill their work and contractual obligations:
a) identification and address data: address, academic title, first name, last name, date of birth, address of permanent residence, delivery or other contact address;
b) electronic contact data: telephone, mobile phone, e-mail address, data box ID;
c) other electronic data: IP address, cookies, authentication certificates, identifiers in social networks and communication platforms (e.g. Skype), location data of the device used by the customer, etc.;
d) other personal data associated with the contractual relationship between AL and third parties: customer account number, health insurance company code, ZTP/P information;
e) other personal data relating to customer records: type of procedures used, frequency of procedures, attendance records for timed procedures, fulfillment of payment obligations from products and services used, personal history information provided by the customer;
f) personal data associated with a video recording of the customer's appearance and his personality when purchasing and using products and services
TO WHAT EXTENT, FOR WHAT PURPOSE AND FOR HOW LONG?
We process the personal data provided by the customer automatically in electronic form or manually in written form due to the fulfillment of obligations from the contract for the provision of services, the provision of services itself, compliance with legal obligations and the legitimate interest of the company and the customer
The customer agrees to the processing of his personal data in the scope specified below (referring to the above letters) for the purposes indicated and for the period indicated below:
- fulfillment of contractual obligations, provision of services, provision of operational activities and fulfillment of legal obligations (in the scope of a) - f) for a period of 3 years);
The customer has understood that the document of customer documentation (so-called personal card) with data at least in the scope of a), b), d), e), which remains in his possession, will be presented by him before each procedure and subsequently returned, identification of the card is required to check immediately.
- sending information messages regarding the agreed products and services, providing advice in the area of product and service selection and warning about the approaching end of validity of time passes or other product vouchers (in the scope of a), b), e) for a period of 3 years);
- analyzing basic information about the customer's state of health in order to exclude possible risks and contraindications from the planned freely offered products and services (in scope a), d), e) for 5 years);
- to send confirmation emails of the electronic order submission system (in the scope of a), b), e) for a period of 3 years);
- verification/evaluation of the customer's records and fulfillment of his payment obligations
(in the scope of a) - f) for a period of 3 years);
- to provide a price offer or grant a discount program from the price in the published price list (in the scope of a), b), d) e) for a period of 3 years);
- obtaining the customer's opinion in order to improve the quality of the products and services provided (in the scope of a) - f) for a period of 3 years);
- collection of statistical data, increased protection of customer rights and AL, and/or prevention of property damage (in the scope of f) for 3 years);
| The customer does not grant consent for the processing purposes listed below and to the extent of this personal data (limitation of consent): | |
| purpose: | range: |
Unless otherwise stated, consent applies to all of the above purposes and scope. The customer declares that he has read and understood this consent and appends his signature as proof.
In Karlovy Vary, on the signature of the customer
………………………………………… ……………………………………………….