Data processing - Consent form

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When Fiom provides services to you, and you have not requested these services on-line, Fiom needs your permission to process your personal data. Please fill out the consent form below to confirm that you allow Fiom to store your data in its systems and that Fiom may use the data to provide services. Your data will be removed from our systems two years after completing our services to you.

Privacy and personal data protection is a top priority to Fiom. You have the right to withdraw or change your permission for the storage and processing of your personal data by Fiom at any given time. Please check our Privacy Code to find more information on this subject.

Usually, we ask your permission for processing your personal data before we start our services. However, in emergency situations, offering urgent help is more important than asking for permission in advance. That is why we are now requesting your permission after all.

Fiom needs your special personal data to be able to provide its services. We use your data only for the purposes you supply them for.

I have read the Privacystatement and I understand that I give Fiom my permission to record my personal data

I agree that my personal data are stored and processed in Fiom’s systems, which is exclusively intended to provide services

I give permission to exchange information with organizations that are involved in my intention to giving up for adoption. This permission expires when Fiom's guidance ends

I hereby declare that I choose domicile at stichting Fiom, Kruisstraat 1, 5211 DT 's-Hertogenbosch

Personal data

First name

Surname

Date of birth

Email address

Phone number

Survey and studies

Fiom is constantly working on improving its services. That is why your opinion about the quality of our services is very important. To find out what you think of our services, we will send you an email once after we have completed our services. This email contains an invitation to participate in our client satisfaction survey. You take part in the survey anonymously and there is no obligation to participate.

Fiom also carries out scientific research. You may be asked to contribute to a study. If you give permission, Fiom is allowed to reach out to you a number of times to ask you if you want to take part in a study. We give you the opportunity to decide right then and there whether you would like to participate or not. Often, the study allows for anonymous participation. You will receive more detailed information on individual studies if you decide to take part in them. You are allowed to withdraw your permission if you change your mind at a later stage. Fiom is then no longer allowed to reach out to you for any future studies.

May we contact you to participate in a scientific study?

Yes

Email address for scientific study

Would you like to receive a copy of this form by email?

Yes

Email address for a copy of this form

Data processing - Consent form

Personal data

Survey and studies

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