“Find an Allergist” Consent Form

Request for approval on publication of clinic/allergy service on klarify, ALK’s consumer care website and app.

klarify is ALK’s consumer care website and app for people who have allergies and who would like more information about allergies.

ALK would like to include details of your clinic(s) or allergy service(s) in the “Find an allergist” tool on the klarify website and app. The tool makes it easy for people to find their nearest clinic or health care provider for allergy service(s). If you see patients in multiple clinics, please feel free to provide information for each location you wish to include in the tool.

The “Find an Allergist” tool is for information purposes only. The listing of a healthcare provider is not meant in any way to act as an endorsement or recommendation to that healthcare provider or to any treatment. All consumers/users are recommended to speak to their healthcare providers when seeking medical advice, treatment, or referrals.

* Required fields

† Selecting a wait time is optional; we will not include a wait time indicator if you choose not to select one of the options. Current wait time definition: Short = less than 2 months, Moderate = 3 to 6 months, Long = more than 6 months. Listing of current wait time will not be used as a recommendation to any particular physician.

Data protection information in accordance with article 13 of the GDPR

The following information is to let you know how we process your personal data and your rights within the meaning of article 13 of the General Data Protection Regulation (GDPR).

1. Who is responsible for the data processing and who can I contact about it?

ALK e-com A/S
Bøge Alle 6 
2970 Hørsholm
Denmark 

Danish company register number (CVR No.): 39266881
email: support-ca@klarify.me

The contact details of our Data Protection Officer are: 
Bech-Bruun Advokatpartnerselskab
CVR no.: 3853 8071
Langelinie Allé 35 
2100 København Ø 
Denmark

Telephone: + 45 72 27 30 02 
E-mail: dpo.alk@bechbruun.com 
Secure E-Mail Function via: https://dpo.bechbruun.com/alk

2. Personal information we collect and process

klarify collects personal information in order to operate the “Find an allergist” tool on the klarify website and app. You provide your personal information to us by completing and submitting the consent form.

Examples of personal data that you may provide to us and which we collect and process are:

• Personal details, i.e. your name, address, email address, telephone number and professional specialty.

3. For what purpose do klarify process your data and on what legal basis? 

klarify processes your data for the purpose of the publication of the data about your clinic(s) or allergy service(s) in the ‘Find an allergist’ tool on the basis of your consent (Art. 6 (1) lit. a GDPR).

4. Who will klarify disclose your data to (recipients of personal data)?

i. klarify’s employees & external processors

The recipients of your personal data will be employees of klarify and external processors providing specific services and processing personal data on klarify’s behalf and in accordance with klarify’s instructions. They will receive your personal data only on a need-to-know basis, being subject to the obligation of confidentiality and after signing appropriate legal documents. No personal data will be disclosed to third parties outside the European Economic Area.

ii. Users of the klarify website and app

Your personal data will be accessed by all users from the klarify website and app when accessing the ‘Find an allergist’ tool. 

5. For how long will your data be stored? 

Your data will be retained only as long as you wish it to be retained. (See “What are my data protection rights?” section below) Or, it will be deleted as soon as it’s no longer necessary for the purpose of processing. This is the case when it’s no longer used for information purposes.

6. Your data protection rights

You may exercise at any time:

• your right of access (Art. 15 GDPR),
• the right to rectification (Art. 16 GDPR),
• the right to erasure (Art. 17 GDPR),
• the right to restrict processing (Art. 18 GDPR),
• the right to object (Art. 21 GDPR),
• the right to data portability (Art. 20 GDPR).  

You have the right to withdraw your consent to the processing of your personal data at any time. If you are not satisfied with the way your personal data is handled, with the data you receive, or with any other aspect relating to the protection of your personal data, please get in touch with our Data Protection Officer.

In addition, you have the right to complain to the Office of the Privacy Commissioner of Canada or the relevant Information and Privacy Commissioner in your jurisdiction of residence. And you are entitled to lodge complaints with an EU supervisory authority (Art. 77 GDPR).

A list on EU's data protection authorities can be found here: https://ec.europa.eu/justice/article-29/structure/data-protection-authorities/index_en.htm.

You may exercise these rights at any time by sending an email to support-ca@klarify.me indicating the right you wish to exercise.

7. Is automated decision-making (including profiling) carried out?

You will not be subject to any decisions based solely on automated processing (including profiling) as defined in Art. 22 GDPR for the publication of information related to the clinic or allergy service in the “Find an Allergist” tool.

By signing and submitting this form to klarify, I grant permission and authorize klarify to publish the information included on this form on the “Find an Allergist” tool in the Canadian klarify website and app. I also certify that I am the individual indicated on this form.