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International Medical Services & Business Development

Official Site of the Medical Center – University of Freiburg

Privacy Consent Form

Privacy Consent Form

Privacy Consent Form Daten (E)
I want to use encrypted E-Mail communication (registration required)*
I have read the Privacy Policy*
Collection of Personal Data*

I agree that personal data may be made available to the following parties under stringent security measures. I have been informed that I may withdraw my consent at any time.

I have been informed that within the framework of my treatment at the Medical Center – University of Freiburg my personal data are collected, stored and, if need be, forwarded for medical, administrational and invoicing purposes to ensure the best possible planning and procedure of my treatment. A CRM (customer relationship management) system is applied. Data transmission follows stringent security measures and is, if possible, encrypted. If my enquiry/ treatment demands, data can be transmitted to any of the following:

  • German embassies and consulates
  • authorities in Freiburg (such as civil registry office, immigrations office)
  • interpreters & translation services
  • ambulance drivers in emergencies (also air ambulance)
  • hotels
  • courier services
  • wheelchair services at airports
  • drivers / taxi drivers
  • other authorities such as customs or the police 
  • pharmacies 
  • financial clearing centers
  • rehabilitation clinics 
  • medically specialised shops such as medical supply stores, opticians, hearing aid acousticians 
  • external physiotherapists 
  • additional medical facilities (e.g. health care centers)
  • funeral services

This declaration of consent is given voluntarily and I may withdraw it at any time. The legality of the data processing shall remain unaffected unless it is withdrawn.

These declarations of consent are given voluntarily and I may withdraw them at any time. The legality of the data processing shall remain unaffected unless it is withdrawn.

To withdraw your consent, please send a letter clearly stating this wish to the following address:

Universitätsklinikum Freiburg
International Medical Services and International Business Development (IMS) 
Breisacher Straße 86b
79110 Freiburg
Germany

Alternatively, you may withdraw your consent online via our website:
https://ims.uniklinik-freiburg.de/en/contact-us/withdrawal-of-consent.html

Universitätsklinikum Freiburg International Medical Services & International Business Development (IMS) – Stabsstelle beim Leitenden Ärztlichen Direktor
Breisacher Straße 86b
D-79110 Freiburg
Phone: +49 761 270 19300, Telefax: +49 761 270 19310
Data protection officer of the Medical Center – University of Freiburg:
UKF Datenschutz
Agnesenstr. 6-8, 79110 Freiburg