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Complaint, Correction, Withdrawal, and Consent Form for Personal Data Processing

Claim Form, Correct, Notice, Request, Withdrawal and Consent Processing of Personal Data

    1. Information of the Complainant

    Name:

    Last Name:

    Contact Number:

    Email:

    2. Purpose of Complaint, Correction, Withdrawal, and Consent for Personal Data Processing

    Under the Personal Data Protection Act B.E. 2562, BSL Clinic Co., Ltd. ("the Company"), as the data controller, is not allowed to process personal data unless the data subject has given prior or simultaneous consent, unless otherwise permitted by law. The company must process data only as necessary for lawful purposes under the data controller's legal rights. The company values compliance with the law based on good governance principles.

    Therefore, if job applicants, employees, business partners, clients, service recipients ("patients"), the general public, still and moving images of patients, or activities organized by the company observe the unlawful processing of personal data, please specify the details of the unlawful personal data processing as much as possible in the form below for the company to investigate and respond accordingly.

    3. Details of Complaint, Correction, Withdrawal, and Consent for Personal Data Processing

    Date and Time the Incident Occurred *

    Details of the Incident and Impact *

    BSL Clinic Co., Ltd. will keep the personal data provided by the data subject confidential and will delete the personal data once the company has completed the investigation of the facts.

    I confirm that the information provided to BSL Clinic Co., Ltd. is true and accurate in all respects. BSL Clinic Co., Ltd. may request additional information from you for the purpose of the investigation.