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Jo, amb DNI
i data de naixement i tel竪fon amb el lloc de treball
i com treballador/a de lempresa
declaro,
Que  accepto /  renuncio al reconeixement m竪dic i a lanal鱈tica de sang i orina que
mha ofert ERGO LABORIS, S. L. en virtut de larticle 22 de la Llei de Prevenci坦 de Riscos
Laborals 31/1995 a trav辿s dels serveis de Vigilncia de la Salut acreditats que t辿 contractats
a aquest efecte.
Aix鱈, manifesto que se mha informat de la necessitat de realitzaci坦 daquests reconeixements
per la millora de la tasca preventiva realitzada al si de lempresa i de que en la seva realitzaci坦
es compleixen tots els preceptes de larticle 22 de lesmentada Llei, tals com, el respecte al
dret a la intimitat i a la dignitat de la persona i la confidencialitat de tota la informaci坦
relacionada amb el seu estat de salut.
Els resultats seran enviats a ladre巽a de correu electr嘆nic que sens facilita:
.
I perqu竪 aix鱈 consti als seus efectes oportuns, signo el present document a de
de 202_.
Signat,
NOTA: una vegada complimentat i signat per cada treballador/a, cal enviar-lo a ERGO LABORIS
per e-mail a vigilanciasalut@ergolaboris.com. s important que en el present document
sindiqui el tel竪fon de contacte, per tal que li pugui arribar un missatge de recordatori de la
cita m竪dica. Aix鱈 com el correu electr嘆nic on rebr els resultats de la revisi坦 medica
efectuada.
ERGO LABORIS SL amb CIF B17800731, adre巽a postal C/ Riera Bugant坦, 5 baixos 17003 Girona, en virtut de la Llei Orgnica
3/2.018 i del REGLAMENT (UE) 2016/679 DEL PARLAMENT EUROPEU I DEL CONSELL de 27 d'abril de 2016, relatiu a la protecci坦
de les persones f鱈siques pel que fa al tractament de dades personals i a la lliure circulaci坦 d'aquestes, destina la informaci坦 que
vost竪/s ens facilita/en, a tractar-la amb la finalitat d'oferir el servei sol揃licitat i requerit. Les dades proporcionades per vost竪s es
conservaran en un fitxer al llarg de la relaci坦 contractual i/o durant el temps necessari de conformitat amb les obligacions
legislatives. Les dades no seran cedides a tercers excepte en casos en qu竪 hi hagi una obligaci坦 legal. Igualment, vost竪 pot exercir
els drets d'acc辿s, rectificaci坦, supressi坦, oposici坦, portabilitat, oblit i limitaci坦 segons estableix la llei esmentada 3/2.018 i el RGPD
2016/679.
Acceptaci坦 / Renuncia Reconeixements m竪dics espec鱈fics
AREA ESPORTIVA
CLUB NUTIC L'ESCALA
X

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RENUNCIA VIGILANCIA DE LA SALUT.pdf

  • 1. Jo, amb DNI i data de naixement i tel竪fon amb el lloc de treball i com treballador/a de lempresa declaro, Que accepto / renuncio al reconeixement m竪dic i a lanal鱈tica de sang i orina que mha ofert ERGO LABORIS, S. L. en virtut de larticle 22 de la Llei de Prevenci坦 de Riscos Laborals 31/1995 a trav辿s dels serveis de Vigilncia de la Salut acreditats que t辿 contractats a aquest efecte. Aix鱈, manifesto que se mha informat de la necessitat de realitzaci坦 daquests reconeixements per la millora de la tasca preventiva realitzada al si de lempresa i de que en la seva realitzaci坦 es compleixen tots els preceptes de larticle 22 de lesmentada Llei, tals com, el respecte al dret a la intimitat i a la dignitat de la persona i la confidencialitat de tota la informaci坦 relacionada amb el seu estat de salut. Els resultats seran enviats a ladre巽a de correu electr嘆nic que sens facilita: . I perqu竪 aix鱈 consti als seus efectes oportuns, signo el present document a de de 202_. Signat, NOTA: una vegada complimentat i signat per cada treballador/a, cal enviar-lo a ERGO LABORIS per e-mail a vigilanciasalut@ergolaboris.com. s important que en el present document sindiqui el tel竪fon de contacte, per tal que li pugui arribar un missatge de recordatori de la cita m竪dica. Aix鱈 com el correu electr嘆nic on rebr els resultats de la revisi坦 medica efectuada. ERGO LABORIS SL amb CIF B17800731, adre巽a postal C/ Riera Bugant坦, 5 baixos 17003 Girona, en virtut de la Llei Orgnica 3/2.018 i del REGLAMENT (UE) 2016/679 DEL PARLAMENT EUROPEU I DEL CONSELL de 27 d'abril de 2016, relatiu a la protecci坦 de les persones f鱈siques pel que fa al tractament de dades personals i a la lliure circulaci坦 d'aquestes, destina la informaci坦 que vost竪/s ens facilita/en, a tractar-la amb la finalitat d'oferir el servei sol揃licitat i requerit. Les dades proporcionades per vost竪s es conservaran en un fitxer al llarg de la relaci坦 contractual i/o durant el temps necessari de conformitat amb les obligacions legislatives. Les dades no seran cedides a tercers excepte en casos en qu竪 hi hagi una obligaci坦 legal. Igualment, vost竪 pot exercir els drets d'acc辿s, rectificaci坦, supressi坦, oposici坦, portabilitat, oblit i limitaci坦 segons estableix la llei esmentada 3/2.018 i el RGPD 2016/679. Acceptaci坦 / Renuncia Reconeixements m竪dics espec鱈fics AREA ESPORTIVA CLUB NUTIC L'ESCALA X