By this, I give my consent to ZU Dental Clinic Simić Dent, located at Vidovdanska 2, 78 000 Banja Luka, BiH, with the decision number of the Ministry of Health and Social Protection no. 11/04-501-39/18, JIB 4403115990006, (hereinafter: Controller), that in accordance with Regulation (EU) 2016/679 of the European Parliament and of the Council of 27 April 2016 on the protection of natural persons with regard to the processing of personal data and on the free movement of such data (hereinafter: Regulation) and in accordance with the Personal Data Protection Act (No. 101/2000 Official Gazette) processes my personal data: first name, last name, date of birth, e-mail, phone.

I give my explicit consent for the processing of personal data provided through the application (web form for appointment booking and contact), through which I provide them to the Controller or to the processor with whom the Controller has concluded an appropriate contract.

I acknowledge:

- that the processing of personal data is necessary for the purpose of enabling communication between me and the Controller for the purpose of negotiating the conclusion of a contract,
- that personal data will be processed for the above purposes for a period of 24 months, unless kept longer according to other legal regulations,
- that providing data is voluntary,
- that withdrawal of consent does not affect the lawfulness of processing based on consent given before its withdrawal.

I have the right to:

- request from the Controller confirmation of whether my personal data is being processed, and if so, access to such personal data,
- request access to personal data,
- request correction of my personal data (in case of incorrect data) and completion of incomplete personal data,
- request deletion of my personal data, restriction of processing of personal data,
- address my legitimate requests to the Controller, and if the Controller does not comply, then to the Agency for Personal Data Protection,
- withdraw my consent at any time free of charge via the e-mail address ordinacija@simicdent.com