** I hereby allow my personal data to be used and stored by the Rendsburg Eye Clinic. My data is to be solely used for the purpose of contacting me and sending advertising materials.
At any time I may retract this consent and require the deleting of my personal data. I do not allow the distribution of my personal data on third parties unless I explicitly state it.
I have read the above data protection agreement and with the sending of this form, I agree and accept it.