Other procedures at External Consultations

Justificants

Per tal de demanar un justificant relacionat amb la seva programació quirúrgica, agrairíem omplís el següent formulari:

Data of the applicant

Name and surname

Email

DNI

Relationship with the patient

Patient data

CIP

Email

Birthdate

Pacient's DNI

Patient's name and surname

Telephone

Message

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

Fields marked with are required.