Reporting a medical incident

    Reporting person (compulsory)

    Reporting person

    Reporting person

    Choose the prefered way of contact

    Patient details

    Product details

    Time/duration of the incident



    Your personal data will be processed in accordance with the Regulation of the European Parliament and of the Council (EU) 2016/679 of 27 April 2016 on the protection of natural persons in regard to the processing of personal data and on the free movement of such data, and repealing Directive 95/46 /EC, General Data Protection Regulation. The Administrator of your personal data is Farmina sp. z o.o., ul. Lipska 44, 30-721 Kraków, Poland, e-mail: Your personal data will be processed solely to report medical incident.
    Your personal data will not be transferred to third parties. You have the right to access personal data, the right to request correction (revision) of personal data - if the data is incorrect or incomplete or the right to request the deletion of personal data. The provision of personal data by you is voluntary.