MonitorME Data Usage Consent Form

MonitorME Data Usage Consent Form

Please complete this form in order to submit usage data from your practice management systems to BEVA office, where it will contribute to nationwide reporting of antibiotic use in UK equine practice
Practice name
Key contact

First NameLast Name
Email
example@example.com
By submitting your practice data to BEVA for this project, you consent to its collection, storage, and processing in compliance with data protection laws, including GDPR and the Data Protection Act 2018. Your data will be anonymised, used solely for this project, and not shared with third parties without your consent, except as required by law. BEVA is committed to protecting your privacy and data security.
Your preferences
If you are happy for your practice to be added to the website, please upload your practice logo

Cancelof
Please confirm if you would like to be added to the mailing list in order to receive reminders for submitting data and receive annual reports for benchmarking. We will provide you with a summary of your antibiotic usage.

I would like to be added to the mailing list
By submitting your information, you acknowledge that you have read and understood this consent form and agree to its terms.

If you wish to withdraw your consent at any time, or have any questions regarding the handling of your data, please contact antibiotics@beva.org.uk.
Signature

Clear
Print your name
Date

DayMonthYear
Date
Should be Empty:

Your preferences