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www.neurotest.fr, Entretien préalable distanciel

Ce questionnaire en ligne constitue la première étape de votre évaluation neuropsychologique réalisée par M. Royer, neuropsychologue.

Les informations que vous allez fournir sont essentielles pour permettre une analyse approfondie et une prise en charge personnalisée. Nous vous remercions d'y répondre avec le plus grand soin.

Afin de garantir l'exactitude des informations et faciliter le remplissage, veuillez vous munir des documents suivants avant de démarrer :

Votre Carnet de Santé
Bilans précédemment effectués (orthophoniste, psychomotricien, neuropsychologique…), merci de nous envoyer les comptes rendus par mail si vous les possédez

Durée estimée : Veuillez compter entre 15 et 30 minutes pour compléter l'ensemble du questionnaire.

Il est possible que certaines informations ne soient pas connues ou disponibles. Afin de faciliter le traitement de votre dossier, veuillez appliquer les consignes de réponse suivantes :

Champ de texte : Si vous ne connaissez pas la réponse, indiquez "Non connu".
Champ numérique : Si la réponse est une valeur chiffrée inconnue, veuillez indiquer "999".

Dès la soumission de ce formulaire :

M. Royer étudiera votre dossier dans les plus brefs délais.

Il reviendra vers vous personnellement par mail pour vous communiquer les conclusions de cette analyse et définir la suite la plus appropriée à donner à votre démarche.

The following survey questionnaire is designed and distributed by Cabinet de neuropsychologie, La chapelle sur Erdre

PURPOSE OF DATA PROCESSING

Objectives

The data processing is aimed at Communication des résultats aux patients.

Legal Basis

Demande d'autorisation préalable.

PROCESSED DATA

Type of processes carried out

Collection, recording, organization, preservation, adaptation, modification, extraction, consultation, use, communication by transmission, dissemination or any other form of provision, alignment or interconnection, locking, erasure or destruction.

Categories of processed data

Données d'identification, anamnèses et coordonnées.

Data Source

These informations are directly collected from the person answering the questionnaire.

INDIVIDUALS CONCERNED

Data processing concerns natural and legal persons answering the questionnaire.

DATA RECIPIENTS

Categories of recipients

Psychologues et secrétaires

DATA RETENTION PERIOD

99 months

SECURITY

We continuously protect your information.

For this, we implement all necessary technical and organizational security measures to protect your data, against any unauthorized access, modification, loss, disclosure, alteration, or destruction.

These measures include:

Bâtiment sécurisé, mots de passes complexes.

YOUR RIGHTS OVER YOUR DATA

The applicable regulation on data protection gives you specific rights that you can exercise, at any time and free of charge, to control the use we make of your data.

Right to access and copy your personal data as long as this request does not contradict trade secrets, confidentiality, or correspondence secrecy.
Right to rectification of personal data that would be incorrect, outdated or incomplete.
Right to request erasure ("right to be forgotten") of your personal data which would not be essential for the proper functioning of our services.
Right to limit your personal data that allows to photograph the use of your data in case of dispute on the legitimacy of a treatment.
Right to portability of your data which allows you to retrieve part of your personal data in order to store or transmit them easily from one information system to another.
Right to give directives on the fate of your data in case of death through you, a trusted third party, or a rights holder.

For a request to be considered, it is imperative that it is made directly by you at the following address secretariat@neuro-psycho.fr. Any request that is not made in this way cannot be processed.

Requests cannot come from anyone other than you. Therefore, we may ask you for proof of identity if there is any doubt about the identity of the requester.

We will respond to your request as soon as possible, within three months of receiving it, in case the request is technically complex or if we receive many requests at the same time.

Please note that we can always refuse to respond to any excessive or unfounded request, particularly with regard to its repetitive nature.

Exercising your rights

The data protection officer is your contact for any request to exercise your rights on this treatment.

Contact the officer by electronic means: secretariat@neuro-psycho.fr

Complaint (grievance) to the CNIL

You can contact the French supervisory authority for data protection (the "National Commission for Information Technology and Liberties" or "CNIL") at any time at the following address: Complaints service of the CNIL, 3 Place de Fontenoy - TSA 80751, 75334 Paris Cedex 07 or by phone at 01.53.73.22.22.

DATA TRANSFER OUTSIDE OF THE EUROPEAN UNION

Uniquement sur dossier anonymisé.

AUTOMATED DECISION MAKING

Uniquement sur dossier anonymisé.

Nous mettons tout en œuvre pour protéger vos données personnelles. Lorsque nous utilisons des logiciels et technologies tierces pour automatiser certaines parties du processus, les dossiers sont préalablement anonymisés.