HCP CONSENT FORM
 


PROJECT DESCRIPTION

This document is to explain to you the purpose of the project, and its operating methods. We invite you to ask any questions you deem useful to the person presenting this document to you.

This project is initiated by the GROUP ETHICA (RESSOURCETHICA and PROPHARMED INTERNATIONAL companies) for the healthcare professionals aiming to improve their service offer and adapt it to your needs.

To this end, the Company wishes to contact you via several communication channels in order to share with you medical information, information concerning launches or specific operations relating to the products which the Company promotes, as well as the list and the agenda scientific events organized by the Group.

This communication may take place via the following channels:

        - EMAIL
        - WEBCAST
        - WEBINARS
        - MOBILE APPS
        - REMOTE VISIT
        - WEBSITES
        - SMS

For this purpose, the Company wishes to obtain the communication of your email address and
your telephone details.



VOLUNTARY PARTICIPATION AND RIGHT OF WITHDRAWAL

You are free to participiate in this project. You can also end your participation at any time and without having to justify
your decision.

You have the right to access, modify, rectify and delete data concerning you. If you decide to end your participation or exercice the aforementioned rights, it is important to notify the Company by contacting it at the following email address : techsupport@propharmedinternational.ch



PRIVACY

The company is required to ensure the confidentiality of participant data collected as part of the Project. In this respect, here are the measures that will be applied within the framework of the Project.

     - Only the Company will have access to the list containing the names, telephone numbers, email address, itself will keep
       the data and the consent forms;
     - Consent forms will be kept within the Company in accordance with applicable regulations;
     - Data in digital format will be kept within the Company in accordance with applicable regulations;
     - Data in digital format will be kept in encrypted files, access to which will be protected by the use of a passeword in
       accordance with applicable regulations.



SIGNATURE:

I, the undersigned Dr , exercising at
, hereby declare having agreed to communicate my email address and my telephone details to receive via the channels mentioned above.

I have read the form and I understand the purpose and nature of the Project. I am satisfied with the explanations, clarifications and answers that have been provided to me, where applicable regarding my participation in this project.



sign on th line above with your hand or mouse