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  1. {% extends 'base.html.twig' %}
  3. {% block stylesheets %}
  4.     {% include 'pdf/mdd/twig/style.html.twig' %}
  6. {% endblock %}
  8. {% block body %}
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  11. <div class="pag">
  12.     <p class="center"><strong>Descrizione del servizio Mappa Centri MDD ed Autorizzazione all’utilizzo dei dati della struttura</strong></p>
  13.     <p>
  14.         <strong>Descrizione del Servizio</strong><br />
  15.         Janssen-Cilag S.p.A., a Johnson & Johnson company, intende implementare il servizio 
  16.         <strong>Mappa Centri MDD (di seguito il Servizio)</strong>. <br />
  17.         Scopo del servizio è inserire all’interno dei siti web di Janssen-Cilag S.p.A., a Johnson & Johnson company, 
  18.         nella sezione dedicata ai medici (Janssen Medical Cloud) e nel portale dedicato ai pazienti (Janssen Con Te), 
  19.         una funzione che permette all’utente di consultare una mappatura/elenco di centri che trattano la depressione maggiore.<br />
  20.         L’obiettivo della funzione è quello di permettere ai pazienti di identificare facilmente quali sono i centri a cui può 
  21.         rivolgersi per la cura della patologia.<br />
  22.         I centri che desiderano essere mappati (far parte dell’elenco), forniranno un consenso attraverso la presente modulistica 
  23.         autorizzando l’inserimento sulle piattaforme sopra citate di: nome della struttura, indirizzo, email, recapito telefonico. 
  24.         Le informazioni pubblicate riguarderanno unicamente la struttura, e non vi sarà trattamento di dati personali relativi a persone 
  25.         fisiche in essa operanti.
  26.     </p>
  27.     <p>
  28.         Cogliamo l’occasione per ricordare che l'operatore sanitario è tenuto a osservare la legislazione corrente in termini di 
  29.         farmacovigilanza e riportare qualsiasi evento avverso, incluse le situazioni speciali*, e/o qualsiasi reclamo di qualità 
  30.         del prodotto ad AIFA<br />
  31.         <a href="https://www.aifa.gov.it/content/segnalazioni-reazioni-avverse" target="_blank">https://www.aifa.gov.it/content/segnalazioni-reazioni-avverse</a>
  32.     </p>
  33.     <p><br /></p>
  34.     <p>
  35.         Janssen-Cilag S.p.A., a Johnson & Johnson company,Janssen-Cilag S.p.A., a Johnson & Johnson company, 
  36.         può rimuovere senza motivo i dati dell'operatore sanitario dalla mappa ma, in caso di rimozione ne darà tempestiva comunicazione.
  37.     </p>
  38.     <p>
  39.         <strong>Autorizzazione all’utilizzo dei dati della struttura e Informativa privacy</strong><br />
  40.         Janssen-Cilag S.p.A., a Johnson & Johnson company (di seguito anche “l’Azienda”), con sede legale in Viale Fulvio Testi 280/6 - 
  41.         20124 Milano, desidera informarla che,sulla base del suo consenso espresso in calce in qualità di 
  42.         <span class="input qualitaDi">{{ mddPdfData.qualitaDi }}</span>,<br />
  43.         Lei autorizza l’Azienda alla pubblicazione del centro/i che afferiscono alla Sua gestione sulle piattaforme 
  44.         sopra citate di: nome della struttura, indirizzo, email, recapito telefonico della struttura.
  45.     </p>
  46.     <p>
  47.         1. I Suoi dati personali verranno trattati (il suo nome e cognome, il suo ruolo e la sua firma) al solo fine di gestire 
  48.         il servizio in oggetto. La pubblicazione sulle piattaforme dell’Azienda Italia avrà ad oggetto unicamente dati riferibili 
  49.         alla struttura, e non anche Suoi dati personali o dati personali di altro personale sanitario in esso operante.
  50.         <br />
  51.         2. Comunicazione dei dati personali. I Suoi dati personali potrebbero essere comunicati alle affiliate del Gruppo 
  52.         Johnson & Johnson per le finalità descritte nella presente Informativa.<br />
  53.         Un elenco di tali società è disponibile all'indirizzo http://www.investor.jnj.com/sec.cfm 
  54.         (fai clic sul link Form 10K, Exhibit 21, sotto "Archivio SEC").<br />
  55.         I Suoi dati personali oltre che ai dipendenti aziendali, potrebbero essere comunicati anche a terzi, quali i fornitori 
  56.         di servizi aziendali utilizzati per supportare le attività di business, come i fornitori di servizi di tecnologia 
  57.         con i quali l’Azienda ha un contratto in essere.
  58.     </p>
  59. </div>
  61. <div class="page_break"></div>
  63. <!-- pag 2 -->
  64. <div class="pag">
  65.     <p>
  66.         3. I Suoi diritti. Ove applicabili, Le sono riconosciuti: il diritto di accedere ai Suoi dati personali, il diritto di 
  67.         richiederne la correzione, la cancellazione, il blocco, la portabilità e la limitazione del trattamento di tali dati. 
  68.         Potrà anche revocare il Suo consenso al trattamento dei Suoi dati personali per le finalità sopra descritte, in qualsiasi 
  69.         momento o fare una richiesta scrivendoci all’indirizzo e-mail: emeaprivacy@its.jnj.com.
  70.         <br />
  71.         4. Trasferimento dei dati personali verso Paesi terzi. Il trattamento e la comunicazione dei dati personali di cui alla 
  72.         presente Informativa possono comportare il trasferimento dei Suoi dati personali a soggetti stabiliti in Paesi al di fuori 
  73.         dell’Unione europea, inclusi gli Stati Uniti, nei quali le norme di protezione dei dati personali potrebbero essere diverse 
  74.         da quelle vigenti in Italia. 
  75.         La legislazione di alcuni Paesi al di fuori dell’UE è riconosciuta adeguata dalla Commissione europea in quanto fornisce un 
  76.         livello adeguato di protezione dei dati in base agli standard UE (l'elenco di questi Paesi è disponibile su 
  77.         https://ec.europa.eu/info/law/law-topic/data-protection/data-transfers-outside-eu/adequacy-protection-personal-data-non-eu-countries_en). 
  78.         Per i trasferimenti verso i Paesi non ritenuti adeguati dalla Commissione europea, l’Azienda assicura che siano state adottate 
  79.         garanzie adeguate, anche assicurando che il destinatario sia vincolato dalle clausole contrattuali standard dell'UE, 
  80.         da un codice di condotta o certificazione approvati, per proteggere i Suoi dati personali. 
  81.         È possibile ottenere una copia di tali misure contattando il responsabile aziendale della protezione dei dati 
  82.         (Data Protection Officer), i cui dati di contatto sono sotto indicati.
  83.         <br />
  84.         5. Conservazione dei dati personali. I Suoi dati personali saranno conservati per il tempo necessario o consentito 
  85.         alla luce delle finalità per le quali sono stati raccolti. I criteri utilizzati per determinare i periodi di conservazione 
  86.         dell’Azienda comprendono: (i) il periodo di tempo in cui è in essere una relazione continuativa con Lei e/o Le viene fornito 
  87.         un servizio; (ii) se esiste un obbligo legale a cui l’Azienda è soggetta; e (iii) se la conservazione è consigliabile 
  88.         alla luce della posizione legale dell’Azienda (come per quanto riguarda le leggi applicabili in materia di limitazioni, 
  89.         contenzioso o indagini normative).
  90.         <br />
  91.         6. Data Protection Officer. In caso di domande sulle pratiche aziendali relative alla privacy, compreso il modo in cui viene 
  92.         determinato il legittimo interesse dell’Azienda come base legale per il trattamento dei dati personali, è possibile contattare 
  93.         il responsabile della protezione dei dati (DPO) scrivendo all’indirizzo e-mail: emeaprivacy@its.jnj.com.
  94.         <br />
  95.         7. Reclami. È possibile presentare un reclamo al Garante per la protezione dei dati personali o ad altra autorità di protezione 
  96.         dei dati competente per il proprio Paese. Le informazioni di contatto per tali autorità sono disponibili su 
  97.         <a href="http://ec.europa.eu/newsroom/article29/item-detail.cfm?item_id=612080" target="_blank">http://ec.europa.eu/newsroom/article29/item-detail.cfm?item_id=612080</a>.
  98.     </p>
  99.     <p>
  100.         AUTORIZZAZIONE ALLA PUBBLICAZIONE
  101.     </p>
  102.     <p class="absolute label_yes">Si, autorizzo</p>
  103.     <p class="absolute label_no">No, non autorizzo</p>
  104.     {% if mddPdfData.autorizzo == 'autorizzo' %}
  105. 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  106.     {% else %}
  107. 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  108.     {% endif %}
  109.     <p>
  110.         all’utilizzo e alla pubblicazione del nome della struttura/e che afferiscono alla Sua gestione e dei suoi recapiti 
  111.         (indirizzo, email, recapiti telefonici) all’interno delle piattaforme digitali Janssen-Cilag S.p.A., a Johnson & Johnson company, 
  112.         per le finalità descritte sopra.
  113.     </p>
  114.     <div>
  115.         <span>Nome e Cognome</span>
  116.         <p class="input nomeCognome absolute">{{ mddPdfData.nomeCognome }}</p>
  117.         <br /><br />
  118.         <span>Data</span>
  119.         <p class="input dataCompilazione absolute">{{ mddPdfData.compilationDate }}</p>
  120.         <br /><br />
  121.         <span>Firma</span>
  122.         <img class="imgURL absolute" height="200" src="{{ signatureBase64 }}" />
  123.     </div>
  124. </div>
  126. {% endblock %}