Being aware of my rights as a data subject concerning the processing, collecting, registering, inputting, storing, arranging, modifying, using, transferring, transmitting, disclosing, blocking or deleting of my personal data and sensitive data, and taking into account Article 11 Paragraph 1 of the PDPL, which provides that: the processing of sensitive personal data is permitted if the data subject has provided his/her consent, thus clearly expressing his/her free will, hereby confirm that I agree to the processing of my data and sensitive data (information about services rendered, duration of treatment, patient history, diagnosis, prescribed medication, etc.) at “Dr. Butkēviča’s dental practice” for the purposes of providing me with medical and health care services.
Step 1: Take a photo of your full face or just your mouth, smiling broadly to show as many teeth as possible.
Step 2: Save photo to your computer
Step 3: Upload the photo by clicking the 'Browse File' button
Step 4: Describe what you are unhappy about with regards to your teeth or what you would like to change.
Step 5: Enter your contact details
Name
E-mail
Phone
