Your Legal Declaration
Important: Please read this declaration carefully before signing and dating the completed form.
1. I declare that all information given to Stemaid Institute
Europe and Poseidonia Medical Centre (hereafter referred
to as the Clinic) is true and complete to the best of my
knowledge and belief whether given. If there has been any
change to the information since it was supplied to you, I
declare that I have set out details of that change in this
4. I confirm that I give explicit consent, within the
provisions of the Data Protection Act 1998, on behalf of
in this form for the clinic to process our personal
information with respect to my medical treatment as set
out in the clinic privacy notice.
2. I understand that if the information I have provided
about myself in answer to the questions in this application
to the clinic is inaccurate or misleading, the clinic may
terminate/amend my treatment and all consequences will
entirely be my responsibility.
5. I understand European Law applies to the agreement
between me and the clinic, unless otherwise agreed
between us in writing.
3. I also confirm that if I had the slightest concern
regarding the status of my personal health, that I have
consulted my Personal Doctor / Medical Practitioner
before signing this form.
You are advised to keep a record of all
information you supply to us in connection with
your Stemaid Institute Europe treatment,
including this medical history form and any
letters. Please save a copy of the form for your
STEMAID INSTITUTE EUROPE PRIVACY NOTICE
The confidentiality of patient and member information is
of paramount concern to the clinic. To this end, we
comply with data protection legislation and medical
confidentiality guidelines. The clinic sometimes uses third
parties to process data on its behalf. Such processing,
which may be outside of the European Economic Area, is
subject to contractual restrictions with regard to
confidentiality and security, in addition to the obligations
imposed by the Data Protection Act 1998.
Medical information will be kept confidential. It will only
be disclosed to those involved with your treatment or care.
All patient documents relating to your treatment are
available to you upon request. Your details and contact
details may be shared between Stemaid Institute Europe
and Poseidonia Medical Centre to enable us to manage
our relationship with you as a clinic customer and update
and improve our records.
In the interest of continuously improving our services to
members, calls may be recorded and may be monitored.
Anonymised or aggregated data may be used by us, or
disclosed to others, for research or statistical purposes.
KEEPING YOU INFORMED:
The clinic, on occasion, like to keep you informed of the
clinic’s products and services that we consider may be of
interest to you. If you do not wish to receive information
about our products and services, or have any other data
protection queries, please write to the clinic:
47a Eleftherias Avenue,
Aradippou, Larnaca, 7102,
or contact us via email at: