In compliance with the provisions of Law 1581 of 2012, which covers general provisions for the protection of personal data, and in accordance with what is stated in the Decree 1377 of 2013 and other regulations that modify, add, or replace, shows that I have been informed by MEDICAL WELLNESS S. A. S. on its Policy on the Processing and Protection of Personal Data.

In virtue of the above, I authorize the release of free, prior, express, voluntary and informed to MEDICAL WELLNESS S. A. S. to collect, store, use, circulate, update, and transmit, in general, to perform the processing of my personal data, including those of a sensitive nature related to my state of health, medical history, photos, clinics, diagnostic images, and other information required for the proper provision of the services of anti-aging medicine, cosmetology services, and other services offered by the institution.

Likewise, I authorize the use of my data for the following purposes:

• Health service provision and administrative.
• Appointments, confirmation and follow up appointments.
• Preparation, updating and custody of the clinical history.
• Billing management, portfolio, and administrative processes.
• Satisfaction surveys and quality improvement.
• Sending of information related to educational campaigns, promotions, events, new services, and business activities of Medical Wellness S. A. S., via phone calls, emails, text messages, WhatsApp, or other authorized means.
  
  

I declare that I have been informed of my rights as the owner of the information, especially the know, update, rectify, request proof of the authorization granted, revoke the authorization and to request the deletion of my personal data, where appropriate, in accordance with the legislation in force.

Also, I understand that the information pertaining to my medical history is protected by the legal reserve, established in the rules governing the provision of health services and may solely be accessed by or disclosed in the cases authorized by law.

I have read, understood, and agree to voluntarily the contents of this authorization.