Medical facilities

Hospitals, clinics and other medical facilities.

Facility name

VAT number

Transport route and date

Required medical support

Contact person

Email address

Phone

Additional information

Privacy information

Controller: Allenort Medway sp. z o.o., ul. Wiejska 11/15, 00-480 Warsaw.

Your personal data is processed by Allenort Medway to conduct email correspondence or establish telephone contact and answer your questions, including presenting Allenort Medway's product offer. The legal basis is Article 6(1)(f) of 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 (GDPR), namely the controller's legitimate interest in presenting information about products and services offered by Allenort Medway.

More information is available in the Privacy Policy.

Do not enter patient information or health data in this form, including in additional information.

Optional choices

These choices are optional, are empty by default and do not affect sending this form. You can withdraw them later.

I agree to receive commercial information from Allenort Medway by electronic means. I understand that I may withdraw this consent at any time, which does not affect the lawfulness of processing based on consent before its withdrawal. I agree that Allenort Medway may process my personal data in the following scope: first name and surname, telephone number, email address, for marketing purposes, i.e. to present me with commercial information about products and services offered by Allenort Medway, during the period before I enter into an agreement with Allenort Medway.

Back to contact

Medical facilities

Cookies on this site