Consent for processing of personal data

Parties
1. Inovatiq Sanitas SRL (“Inovatiq”)
2. The undersigned patient/ carer, (“patient/ carer”) ………………..

Inovatiq, legally represented by Alina Comanescu, process personal data in order to be able to coordinate
and to fulfill assignment for the medical care that patient/ carer have requested. The handling of the patient/
carer’s personal data is governed by several laws, such as the Patient Data Act, the Data Protection
Regulation, the Public and Privacy Act and the Archive Act.

The Patient/ carer have accepted that Inovatiq processes the Patient/ carer’s personal data, including
sensitive personal data. The Patient/ carer has accepted that his/her personal data will primarily be
processed by concerned parties at Inovatiq and its subcontractors and may be used for necessary
documentation, assessment of possibilities to provide medical care, assessment of appropriate care,
necessary documentation during and after care, billing, process development, obtaining statistics, possible
future reconnection to patient case, to secure traceability and therewith consistent measures.

The Patient/ carer has given Inovatiq permission to transfer all relevant personal data to concerned
authorities and/or health care centres abroad if deemed necessary due to future care or for any other
significant reason.

The Patient/ carer has given Inovatiq permission to, at any given time and without exception, access the
patient records as drawn up by Inovatiq’s subcontractors due to the Medical Services.

The Patient/ carer has been informed that the Patient/ carer have the right to withdraw their consent at any
time. However, note that withdrawal of their consent does not affect the legality of the treatment before the
consent was revoked, no more personal data will be collected, but all data collected up to that time may be
retained.

The Patient/ carer may at any time submit, once per calendar year without charge, a written request in order
to be informed about what personal data Inovatiq holds about you, including how the personal data is
processed and the right to correction of data in cases where the registered data would not be correct and in
some cases to have the data deleted. The rights depend on the legal basis on which the processing of
personal data rests. This means that certain rights apply only under certain conditions.

Date
Inovatiq Sanitas SRL …………………..