Form to ask info about products

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Product
Name
Surname / Company Name (*)
Hospital / Clinic / Private
Location (*)
Tel (*)
Email (*)
Info
CONSENT TO PERSONAL DATA PROCESSING L. 196/03
By completing and sending this form you agree to the following (in accordance with Article 13 Law 196/03 on privacy).
Data collected on this occasion will be used by the company owning this web site solely for internal purposes and for sending and dissemination of information material.
They will not be communicated or disclosed to third parties.
enjoys the rights provided by law 196/03.
Owner and manager of the data collected is the company owning this web site.