INFORMATION & CONSENT STATEMENT
REGARDING PERSONAL DATA

Dr. Georgios Mavropoulos, who maintains a medical practice in Neos Kosmos, informs you
regarding the processing of your personal data:

(1) In accordance with Article 14 of Law 3418/2005 (Code of Medical Ethics), the maintenance of a medical record is mandatory, in which the following are recorded: full name, father’s name, gender, age, occupation, patient’s address, dates of visits, health complaints, reason for the visit, primary and secondary diagnosis or treatment followed, and results of clinical and paraclinical examinations. This record is maintained, in accordance with the law, for a period of 10 years following your last visit.
(2) The physician implements the necessary security measures to safeguard your personal data.
(3) As a patient, regarding your personal data, you have the following
rights:
 Right of access to your data: The right to know whether your
data are being processed, how, and for what purpose.
 Right to rectification of your data: The right to request the correction of your personal data if it is inaccurate or incomplete.
 Right to erasure of your data (“right to be forgotten”): The right to request the deletion or removal of your personal data, subject to certain conditions and following the expiry of the aforementioned ten-year period.
 Right to restriction of processing of your data: The right to request the restriction of the processing of your personal data when certain conditions are met.
 Right to data portability: Your right to request that your data be sent to a third party (e.g., another doctor).
 When you submit a request exercising any of the above rights,
The physician is required to respond to you within one month, either by fulfilling the request (e.g., by providing a copy of your medical file), by rejecting your request with a stated reason (e.g., refusing a request for deletion because the law mandates that the physician retain the records for 10 years), or by explaining the reasons for any delay. In any case of delay, the physician must provide a response—whether positive or negative—within three months of the request.

(4) Provided you give your consent, the doctor will use your personal data for the following purposes:

To make use of the access provided by the system ☐ YES ☐ NO

IDIKA’s electronic prescribing system in order to retrieve
information regarding the history of all types of prescribed
medicines and medical tests
Telephone contact with you to arrange a follow-up visit. ☐ YES ☐ NO
Updates regarding your health matters. (If you do not provide your consent, the
physician will not use your contact details, unless necessary to protect
your vital interests or those of third parties, or for reasons of
overriding public interest).

☐ YES ☐ NO

Taking photos to monitor the progress of your health. ☐ YES ☐ NO

Posting your photos online in a way that ensures your identity is not revealed, either directly or indirectly.

☐ YES ☐ NO

Communicating with you regarding various updates concerning the practice’s activities.

☐ YES ☐ NO

You may select either some or all of the above purposes.
In any case, please note that every physician is bound by the Code of Medical Ethics
to safeguard medical confidentiality and protect their patients’ data.
I have read and understood all of the above and have freely chosen the purposes
for which I wish—or do not wish—to provide my consent.
Date ……
PATIENT’S FULL NAME: ………………..
(In the case of a minor under 16 years of age: Full name of the person exercising parental
responsibility:………………………………………………)
Signature ———————————