Acknowledgements and Certification

I hereby certify that I have read and acknowledged the entire Hospital's Privacy Policy.

I certify that the personal data filled in this form is true, correct and current. In case I fill in on behalf of other persons, I confirm that I have obtained their consent or have a legal right to disclose their personal data to the Hospital.

Consent
I grant my consent to the Hospital to collect, analyze, process, use and disclose my personal data and send me information about products, services, advertisements, or promotional campaigns that will benefit me through all channels I have provided to the hospital.