Name Surname Fiscal code Occupation Address ZIP City Country Email Phone number I am interested in LIRH as: patient familiar physician other Inserisci un importo Statute acceptance READ OUR STATUTE PURSUANT TO THE EUROPEAN REGULATION N. 679/2016 ON THE PROTECTION OF PERSONAL DATA, WE INFORM YOU THAT THE PERSONAL DATA COMMUNICATED BY YOU IN THIS FORM WILL BE PROCESSED BY THE LIRH FOUNDATION - The Italian League for Research on Huntington, Via Varese 31, Rome IN COMPLIANCE WITH THIS LAW, AS WELL AS IN COMPLIANCE WITH CONFIDENTIALITY OBLIGATIONS. WE INFORM YOU THAT YOUR PERSONAL DATA WILL BE INSERTED IN THE INSTITUTIONAL DATABASE 'CRM LIRH' VERSION 1.0 OF 16.10.2018 AND WILL BE USED EXCLUSIVELY TO SEND YOU INFORMATION AND UPDATES ON SOCIAL AND SCIENTIFIC INITIATIVES OF THE “LIRH FOUNDATION" . IF YOU DO NOT WANT TO RECEIVE OUR COMMUNICATIONS ANYMORE, PLEASE SEND US AN E-MAIL AT INFO@LIRH.IT AND WE WILL DELETE IT FROM OUR CONTACTS. I authorize the processing of the data provided for the purposes related to the declared activity authorize not authorize Submit subscription request
