Information notice and consent form
for accessing the Concilio services

Information notice and consent form – (18/07/2018)

Would you like to use the Concilio services? (Find out more).

The Information Company is the data controller within the meaning of the provisions of the amended Data Protection Act 78-17 of 6 January 1978 relating to information technology, files and personal liberties and EU Regulation 2016/679 of 27 April 2016 (“GDPR”) on the protection of private individuals with regard to the processing of personal data and the free movement of this data, which are hereinafter collectively referred to as the “Regulations”.

• The Information Company is therefore responsible for the processing of your personal data collected for administrative and health purposes and processed in order to enable you to use the Concilio services, which you may select via the website https://www.concilio.com/en for the following purposes:
  • To identify doctors and make appointments with them,
  • To prepare your medical consultations,
  • To provide healthcare information.
• TELMED, as a telemedicine organisation, is responsible for the processing of your personal administrative and health data collected and processed so you can use the teleconsultation service offered by eachdoctor providing teleconsultation.

Your administrative and health data, once made strictly anonymous, may also be the subject of analyses and statistical studies in compliance with the provisions of the amended regulations relating to information technology, files and personal liberties.

The Information Company and TELMED, as well as any subcontractors they may use, will apply adequate safeguards for the implementation of appropriate technical and organisational measures, in particular, in terms of confidentiality and security.

In particular, you are informed that your personal health data is hosted by an authorised health data provider, ATE, a simplified joint-stock company with a capital of 60,000 Euros, having its registered office at 21 avenue de la créativité , 59650 Villeneuve d’Ascq and registered in the Lille Trade and Companies Register under number 347 607 764, in accordance with the provisions of Article l. 1111-8 of the Public Health Code. You have a right of opposition that you can exercise using the following email address: droit_acces@concilio.com

Enhanced security measures are implemented to enable the collection and processing of your administrative and health data under the conditions that guarantee their confidentiality, integrity and, more generally, their security in compliance with the regulations.
 

In particular, you are informed that your personal health data is hosted by an authorised health data provider, ATE, a simplified joint-stock company with a capital of 60,000 Euros, having its registered office at 21 avenue de la créativité , 59650 Villeneuve d’Ascq and registered in the Lille Trade and Companies Register under number 347 607 764, in accordance with the provisions of Article l. 1111-8 of the Public Health Code. You have the right of opposition that you can exercise using the following email address: droit_acces@concilio.com

Your personal data (including your administrative data and your health data) is strictly used for:

– The Concilio doctor and only authorised personnel under his/her supervision,

– In addition, the doctors with whom you will be in contact in the course of the various services,

– The strictly authorised personnel of the health data host, within the limits of their respective duties;

– Your doctor, for sending the teleconsultation report, which you have been given, subject to your agreement;

– The pharmacist of your choice to send a prescription, if necessary;

– Strictly authorised personnel working for the technical subcontractors of CONCILIO and TELMED, within the limits of their respective duties

You are informed that in no event will your health data be transmitted to your employer, insurer or any other body financing the service that has entered into an agreement with CONCILIO or TELMED in order to enable you to use the services.
 

Your personal data will be held for the duration of your contractual relationship with CONCILIO and will be archived for a period of ten years (10), after which it will be deleted.
 

In accordance with the Regulations, you may exercise:

– The right to access your personal data and to request corrections.

– The right to oppose and to delete your personal data.

– The right to communicate your instructions regarding what happens to your personal data after your death.

You also have:

– The right to withdraw your consent at any time.

– The right to restrict processing;

– The right to be forgotten and to erasure;

– The right to the portability of your data;

– The right to lodge a complaint with the CNIL (French National Commission for Data Protection and Liberties).

In order to exercise your rights, you can contact one of the following authorities, providing a copy of proof of your identity:

• by post to the Médecin Concilio – The Information Company: 20 bis rue louis Philippe, 92200, Neuilly-sur-Seine, or by email at droit_acces@concilio.com
• the Doctor of the Health Data Host at 21 avenue de la créativité, 59650 Villeneuve d’Ascq;

The data protection officer can be contacted at the following email address: droit_acces@concilio.com.
You can contact the officer with any questions regarding your personal data.

By clicking on the checkbox below (via the website https://www.concilio.com), you expressly agree to give your consent to the collection and processing of your personal health data, in order to use the Concilio services that interest you and, in particular, the teleconsultation service.

In accordance with the amended Data Protection Act 78-17 of 6 January 1978 relating to information technology, files and personal liberties, you have the right of access, rectification and opposition relating to your data. To exercise these rights, you can contact directly:

Médecin Concilio – The Information Company

by mail at the following address: 20 bis rue Louis Philippe, 92200, Neuilly-sur-Seine,
or by email at droit_acces@concilio.com ;

You may, if you wish, print a copy of this information notice and consent form.

_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

Consent

☐ I hereby consent to the collection and processing of my personal health data as part of the Concilio services,

☐ I hereby consent to the collection and processing of my personal health data as part of the teleconsultation service

☐ I hereby authorise the report from the teleconsultation I have received to be sent to my doctor.

☐ I hereby authorise my prescription to be sent to the pharmacy of my choice.

☐ I hereby acknowledge having read the terms and conditions of use and accept them without reservation.

Date :

Signature :