GDPR consent declaration

I, the undersigned _________________________________, residing at _________________________________, e-mail ________________, telephone _______________, as a patient of Didenta Implantology Art:

Declare that I have read and taken note of the Information notice on the processing of personal data:

☐ YES    ☐ NO

I give my express, free, unambiguous and specific consent regarding:

1. Receiving information about medical products and services

☐ YES    ☐ NO

Via: ☐ SMS   ☐ e-mail   ☐ telephone call   ☐ post   ☐ social media platforms

2. Processing for promotional and advertising purposes

☐ YES    ☐ NO

Of the following data: ☐ voice and/or image   ☐ testimonials   ☐ details about treatments   ☐ first name and last name

First name and last name are processed for promotional purposes only together with at least one other category above.

Methods: ☐ social media posts   ☐ advertising materials   ☐ online/offline advertising   ☐ clinic website

Withholding consent does not affect the provision of medical services.

Consent remains valid until withdrawn. Withdrawal / amendment: office@didenta.ro or the address Str. Padeșu nr. 8, bl. 5, sc. 2, et. 8, ap. 52, Sector 4, Bucharest.

Signature: _____________________    Date: _____________________

This form is intended for completion at the clinic. For consents on the Website, the checkboxes in the online forms are used.

Last updated: 26 August 2026