Informed Consent

Informed Consent:

  • The service provided by Dr. Sana Barada, pharmacologist specialized in addiction studies, consists of training and tutoring regarding the undersigned’s personal well-being status, based on their specific requests.
  • For this purpose, educational tools may be used for prevention, training, and tutoring in the field of behavioral support.
  • For this purpose, educational tools may be used for prevention, training, and tutoring in the field of behavioral support.
  • The fee for the services provided has been clearly specified, and the undersigned has been fully informed that the amount paid for the service received is non-refundable. The undersigned acknowledges and accepts that no full or partial refund may be requested for services already provided.
  • In the event of inability to attend a scheduled appointment, the undersigned agrees to provide at least 24 hours’ notice to reschedule. Failure to provide such notice will result in forfeiture of the amount paid for the professional service that was not cancelled within the required 24-hour period.
  • In the case of an agreed program established under a personalized plan, the undersigned may discontinue the service at any time. In order to ensure the best possible outcome of the process, the undersigned agrees to communicate the intention to discontinue the program to Dr. Barada and, at their sole discretion, may participate in a final session intended to summarize the work completed up to that point. The undersigned further agrees to pay all fees relating to services/hours received up to the date of termination.
  • The specialist is required to maintain seriousness and professionalism in carrying out the assignment.
  • An agreement has been made between the undersigned and Dr. Barada that the personalized educational program will be clearly explained during the sessions following acceptance of this consent form.
  • The undersigned releases Dr. Barada from any responsibility regarding the manner in which the information provided is used, acknowledging that the information supplied is scientific in nature and does not constitute therapy or medical advice.
  • Any dispute concerning the interpretation, application, or execution of this agreement shall be governed exclusively by Italian law and subject exclusively to the jurisdiction of the Italian courts.
  • The undersigned acknowledges that the processing of personal data is protected in accordance with the principles established by GDPR Regulation 2016/679 (see Privacy Policy document) and therefore authorizes Dr. Barada to view and process personal information related to the objectives of the agreed educational program.

 

In the Case of a Minor: having been fully informed of the above, we (the mother and father/legal guardians of the minor) consent to our child receiving the agreed service with Dr. Sana Barada..

Privacy Policy - Unified Form for Professional Services

The undersigned has been informed of the following points regarding informed consent:

  1. the service provided concerns training/tutoring in the field of addictions.
  2. the service is aimed at prevention, education, and tutoring activities relating to addictions.
  3. the primary tools used to achieve these objectives will include interviews and educational sessions.

 

Information Regarding the Processing of Personal Data Pursuant to EU Regulation 2016/679 (GDPR):

  1. EU Regulation 2016/679 (hereinafter “GDPR”) provides and strengthens the protection and processing of personal data in accordance with the principles of fairness, lawfulness, transparency, confidentiality, and the protection of the data subject’s rights.
  2. Dr. Sana Barada is the Data Controller of the following data collected for the performance of the services covered by this agreement:
    1. Personal, Contact, and Payment Data – information relating to: name and surname, telephone number, email address (including certified email where applicable), payment information relating to professional fees (e.g., credit/debit card details), etc.;
    2. Sharing of Personal Data: personal data may be shared with individuals authorized by the Data Controller who have signed confidentiality agreements, including: specialist physicians, subjects, entities, or authorities where required by law;
    3. Legal Basis for Processing: the legal basis for processing is the performance of contractual and pre-contractual obligations. Consent is mandatory.
  3. Personal data may be processed in paper, electronic, and/or automated form, using both manual and digital methods. In all cases, appropriate procedures will be adopted to ensure confidentiality, in compliance with applicable laws and professional secrecy obligations.
  4. Appropriate security measures will be implemented to guarantee the protection, security, integrity, and accessibility of personal data.
  5. Personal data will be retained only for the time necessary to fulfill the purposes for which it was collected or for any other legitimate related purpose.
  6. Personal data that is no longer necessary, or for which there is no longer a legal basis for retention, will be irreversibly anonymized or securely destroyed.
  7. Data Retention Periods:
    1. personal, contact, and payment data: retained for the time necessary to manage contractual and accounting obligations and subsequently for a period of 10 years;
    2. data relating to health status: retained only for the period strictly necessary to carry out the assignment and pursue the related purposes, and in any case for a minimum period of 5 years (Article 17 of the Italian Psychologists’ Code of Ethics).
  8. The list of data processors and other parties with whom data may be shared is available upon request.
  9. Where applicable and subject to the conditions related to the execution of the assignment, the data subject may exercise the rights provided under Articles 15 to 22 of the GDPR, including: access to personal data, rectification, erasure, restriction of processing, receiving a copy of personal data in a structured, commonly used, machine-readable format, transmission of such data to another data controller.

Having read and understood all of the above, the undersigned acknowledges and accepts these terms on their own behalf.

In the Case of a Minor: Having read and understood all of the above in the exercise of parental responsibility over the minor.

Having received appropriate professional information and adequate explanations regarding the purposes and methods of the services provided, the undersigned freely consents to the services and fee estimate described above and HEREBY GIVES CONSENT.

Having received appropriate information regarding the processing of personal data, including data relating to health status, the undersigned freely consents to the processing and communication of personal data for all purposes indicated in this notice and HEREBY GIVES CONSENT.