Consent for the processing of personal data

To COLDY DENT Functional Atelier
city of Sofia, Manastirski Livadi residential
area, Street 2, Bulgarska legia Str.
Phone: +359 89 659 3939
e-mail: office@coldydent.com

1. Data subject: …………………………………………………………………………………….
   /please, indicate two names/
2. Contact details (e-mail, phone)
   ………………………………………………………………………………………………………………….
3. I give my express consent to the collection, processing and storage of personal data provided
   by me by COLDY DENT Functional Atelier
   1) in respect of the following personal data
   ………………………………………………………………………………….
   2) for the following purposes
   .…………………………………………………………………………….
   2) in the following operations
   .…………………………………………………………………………….
   I declare that before giving this consent, I was provided with the personal data protection and
   processing policy of COLDY DENT Functional Atelier, with which I am familiar.
   I declare that I have been informed that my refusal to give consent will not affect my rights, nor
   will result in COLDY DENT Functional Atelier refusing to provide services, nor will affect me
   in any negative way.
   I declare that I have been informed that I can withdraw the consent given by me at any time, and
   that withdrawal of consent will in no way affect my rights and the services provided to me.
   Withdrawal of consent will result in the cessation of activities that are based on consent as a
   basis for processing personal data.
   Signature: ………………………….