CENTRO ESCOLAR UNIVERSITY

Manila * Makati * Malolos

PRIVACY NOTICE AND INFORMED CONSENT FOR

HEALTH SERVICES DEPARTMENT
I. STATEMENT OF POLICY
Centro Escolar University is committed to respect and value the privacy rights of individuals. We will ensure that all personal data are protected
and processed in accordance with Republic Act No. 10173 or the Data Privacy Act of 2012 and its Implementing Rules and Regulations. We recognize
the confidentiality of personal data and adhere to the general principles of transparency, legitimate purpose, and proportionality.
II. DATA PROCESSING
CEU shall process your personal data where a legitimate educational or institutional interest exists as determined by CEU and as may be provided
under the law.
Collection
The personal data that CEU shall collect may include, but not limited to: Name; birthdate; age; address; nationality; sex; religion; civil status;
education; results of laboratory and other diagnostic tests; personal contact information; emergency contact information; medical/dental information;
medical/dental history and physical examination findings; photo; privileged information, and other information that may be relevant for diagnosis,
treatment/management, availment of healthcare services and clinic operations.
The method of collection of personal data shall be through manual or electronic forms; interviews; or databases that are shared between the
University and its different units and outside health service providers and during enrolment; consultations; emergency cases; physical examinations or at
any time when necessary.
Use / Purpose
The data collected shall be used for legitimate purposes, such as but not limited to: diagnosis; treatment/management; determination of fitness for
various purposes; personal and public health and safety; record-keeping; preparation of reports; University health and wellness program; research or
profiling; generation of statistical/epidemiological data relevant to the Clinic’s operations; availment of various healthcare services; application for
hospitalization/insurance benefits and other health-related claims; compliance to government requirements and verification of medical documents.
Only authorized CEU personnel who are necessary in facilitating the service you require have access to your personal data and automated access to
the Dental and Medical Database are secured and limited to personnel duly issued with a username and password.
Sharing and Disclosure
CEU shall keep all personal data in strict confidentiality if such data are not intended for public disclosure. There will be instances however where
sharing and disclosure will be undertaken pursuant to a legitimate academic purpose or as determined by CEU in order to promote your best interests.
In order to function in accordance with the services provided by this department, we may share your personal data with the Health Services Head
and staff, as well as with the Management Council and units or offices within CEU, when necessary. We may also share your personal data with your
family members, guardian, significant others, companions during emergencies or with others on a need-to-know basis. Pertinent data may be reported
and disclosed to a hospital where you are confined or referred and/or specialists attending to you, including accredited third party medical service
providers and regulatory authorities or government agencies when required or allowed by law.
Storage and Retention
CEU shall store your personal data and medical and dental records in a secure place at the Health Services, protected against any accidental or
unlawful destruction, alteration and disclosure as well as against any other unlawful processing.
All personal data and Medical Health Record and Dental Health Record shall be retained for up to one year from the day of separation from the
University or the termination of employment, and for up to one year from the date of graduation of the students. However, relevant personal data needed
for medical, historical and statistical purposes may be retained indefinitely, as well as the Dental and Medical Database. The period of retention may
change without prior notice, depending on relevant school policies, department needs, or government regulations.
Disposal
Generally, within one year from end of employment or graduation of student, the Medical Health Record and Dental Health Record shall be disposed
and destroyed through secure means.
The modes of disposal may include: shredding; deletion of electronic records and destroying of storage media.
STATEMENT OF DATA SUBJECT RIGHTS UNDER THE DPA
CEU recognizes and respects your right to be informed, to access, to correct or rectification, to erasure or blocking, and to object to the
processing, the right to damages and to lodge a complaint before the National Privacy Commission, as provided under the DPA.
III. INQUIRY
For any concern pertaining to your personal data such as access to your information, correction or rectification of data, erasure or blocking, as
well as to report any actual or suspected data breaches or security incidents, you may write to us, stating therein the details of your request or report and
addressed to the Data Protection Officer or any member of the Data Privacy Response Team:

Dr. Maria Corazon L. Andoy - Compliance Officer for Privacy (COP) Centro Escolar University
259 Sen. Gil Puyat Ave. Makati City
Email: clandoy@ceu.edu.ph Tel. No. 843-7356

I HAVE READ AND UNDERSTOOD THE PRIVACY NOTICE OF THE HEALTH SERVICES DEPARTMENT AND I HAD THE OPPORTUNITY TO ASK
QUESTIONS ABOUT MATTERS NOT CLEAR TO ME. I AGREE TO THE PROCESSING OF MY PERSONAL DATA, INCLUDING SENSITIVE
INFORMATION, SUBJECT TO THIS PRIVACY NOTICE.

PRINTED NAME OF STUDENT Samantha Nicole C. Tacad

SIGNATURE
DATE SIGNED January 19, 2022

(If MINOR – 18y/o and Below)

PRINTED NAME OF PARENT/GUARDIAN Bernadine C. Tacad
SIGNATURE
DATE SIGNED January 19, 2022