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Last Name *

Affiliation (Institution or Company) *

Institution/Company Address *

Are you a student? *
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Do you hold a doctorate degree? *
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What field do you work in? *

Are you attending the banquet on Saturday? *
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Address*

City*

State/Province*

Postal Code*

Country*
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Registration Type*?
Regular Attendee - $200Trainee or Student - $50

If Trainee or Student, please provide your Advisor's Name:

I hereby consent to the collection, storage and use of my personal data for the registration and participation in the "2023 International Conference on Complex Acute Illness ICCAI" from September 8. – 10., 2023 in Augsburg by the
Augsburg University Hospital
Institute for Digital Medicine (IDM)
Stenglinstr. 2
86156 Augsburg
Email: sekretariat-idm@uk-augsburg.de
Tel.: +49 821/400-9520

1. The following personal data are collected and processed:
a) Personal details/data (first and last name, address data, professional status data, email address, telephone number and IP address for the registration process), Image captures (if consent is given).
b) Bank data (e.g. PayPal or credit card institute and number).

2. Data transfer:
Your personal data will be transferred to a third country/international organization (Society for Complex Acute Illness/USA). The above data, if collected, will be stored on the servers of the Society forComplex Acute Illness (SCAI)/USA and will be made available to UKA as the organizer of the congress for preparation and implementation. In order to maintain data protection adequacy, standard contractual clauses have been concluded with SCAI between data controllers and processors in accordance with Article 28 (7) GDPR.
Nevertheless, the possibility may exist that unknown third parties (e.g. intelligence services, etc.) access personal data. This existing risk cannot be excluded by the precautions taken. For this reason, the information requested to provide personal data is limited to the minimum necessary.

Your data (name, professional status) will be passed on to the German Research Foundation DFG to obtain funding for the congress and, if requested, to the Bavarian Medical Association BLÄK for crediting of continuing education points.

3. Declaration
With my registration, I consent to the processing and disclosure of my personal data to the above-mentioned third parties. I am aware of my rights, in particular to revoke this consent, and have become aware of them through the handed over/linked information requirements according to Art. 13 GDPR. I can revoke this consent at any time in writing (Augsburg University Hospital, Institute for Digital Medicine, Stenglinstr. 2, 86156 Augsburg, Germany) or by email (sekretariat-idm@uk-augsburg.de) with effect for the future.

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