预约

健康体检项目

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患者信息

患者信息
是否有患者在峨山医院?
出生日期
性别
国籍
电子邮箱 电话号码

预约详情

Preventative Health Screening Information
首选检查项目
选择日期
药物摄入量 (0/300 个字符 )
病史 (0/300 个字符 )
酒店地址
注释 (0/300 个字符 )

Asan Medical Center needs your consent to the collection, use and provision of your private information to a third party as follows in accordance with Article 15, Section 1, No.1, Article 23, Section 1, No.1 and Article 24, Section 1, No.1 of the 「Personal Information Protection Law」.

Personal Information CollectionㆍUse Consent

1. Purpose

Collection of Information for the operation of “Asan Medical Center Health Screening and Promotion Center health check-up appointment”

2. Collected Information

Personal Information: Name, Gender, Date of birth, Nationality, Phone number, Email address, Hotel Address, Preferred check-up program & Date, Comments.

3. Retention and period of use

The collected personal information is retained and used only during the service provision period for [Purpose of Collection and Use of Personal Information], and the information collected for the provision of medical services is kept in accordance with the Medical Act.
However, even if the purpose of collection and provision has been achieved, personal information may be retained if there is a need to keep it according to other laws and regulations.

4. Right to refuse the consent and disadvantages in case of refusal

You can refuse consent to the provision of the stated items, but please inform you that the health check-up reservation service is not available, if you do so.

I consent to the collection and use of my personal information as the above.      

Sensitive Information Collection·Use Consent

1. Purpose

Collection of Information for the operation of “Asan Medical Center Health Screening and Promotion Center health check-up appointment”

2. Collected Information

Sensitive Information : History of disease & drug

3. Retention and period of use

The collected personal information is retained and used only during the service provision period for [Purpose of Collection and Use of Personal Information], and the information collected for the provision of medical services is kept in accordance with the Medical Act.
However, even if the purpose of collection and provision has been achieved, personal information may be retained if there is a need to keep it according to other laws and regulations.

4. Right to refuse the consent and disadvantages in case of refusal

You can refuse consent to the provision of the stated items, but please inform you that the health check-up reservation service is not available, if you do so.

I consent to the collection and use of my Sensitive Information as the above.      

CAPTCHA

如果您有私人保险,您可以亲自向您的保险公司收取费用。