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Vull informació sobre l'estat de la llista d'espera
Per tal de sol·licitar informació sobre l’estat de la llista d’espera, agrairíem omplís el següent formulari:
Data of the applicant
Name and surname
Email
DNI
Relationship with the patient
Relationship with the patient
- Select -
Mother
Father
Pacient
Legal Guardian
Direcció General d’Atenció a la Infància i l’Adolescència (DGAIA)
Residential centre
Other…
Enter other…
Documento justificativo
Upload
Upload requirements
One file only.
2 GB limit.
Allowed types:
txt, rtf, pdf, doc, docx, odt, ppt, pptx, odp, xls, xlsx, ods, gif, jpg, jpeg, png
.
Patient data
CIP
Email
Birthdate
Pacient's DNI
Patient's name and surname
Telephone
Observaciones
I declare, under my responsibility, that I am over 16 years of age, and I am solely responsible for the accuracy of the declaration.
I accept the Data Protection Policy
You can find the information about the data protection policy by clicking on the following link ->
Legal notice
Information on the processing of personal data:
Legal basis for processing:
Exercise of public powers, fulfilment of a legal obligation.
Responsible:
Hospital Universitari de Bellvitge
- Institut Català de la Salut.
Purpose:
To manage the contact of citizens, to resolve issues related to their health by telematic means.
Legitimation:
Express acceptance of the privacy policy.
Rights of interested persons:
Access, rectification, deletion and portability of data, limitation and opposition to its processing, by contacting you by e-mail at
uac@bellvitgehospital.cat
or by post.
- Hospital Universitari de Bellvitge
- Carrer de la Feixa Llarga, s/n
- 08907 L’Hospitalet de Llobregat
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