B4C Help Desk

Welcome! You can raise a request from the options provided.

Contact us about

Support Brazil

What can we help you with?

(BR) Subject Access Request (SAR)

Required fields are marked with an asterisk

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Detalhes dos registros de pacientes/clientes/membros da equipe a serem acessados"}]},{"type":"paragraph","content":[{"type":"text","text":"(Por favor complete um formulário por pessoa)"}]},{"type":"layoutSection","content":[{"type":"layoutColumn","attrs":{"width":50},"content":[{"type":"extension","attrs":{"extensionKey":"question","extensionType":"com.thinktilt.proforma","layout":"default","parameters":{"id":30},"localId":"51fd53d8-b742-48be-94de-6968fc0c71da"}},{"type":"extension","attrs":{"extensionKey":"question","extensionType":"com.thinktilt.proforma","layout":"default","parameters":{"id":2},"localId":"b9c4c8c7-f680-43b5-bb0d-837488e1a8c7"}},{"type":"extension","attrs":{"extensionKey":"question","extensionType":"com.thinktilt.proforma","layout":"default","parameters":{"id":4},"localId":"2212d1d7-5192-4f4b-b41f-501ad0818903"}},{"type":"extension","attrs":{"extensionKey":"question","extensionType":"com.thinktilt.proforma","layout":"default","parameters":{"id":25},"localId":"b8c79994-1e83-4ee8-bd37-be9f76f5790c"}}]},{"type":"layoutColumn","attrs":{"width":50},"content":[{"type":"extension","attrs":{"extensionKey":"question","extensionType":"com.thinktilt.proforma","layout":"default","parameters":{"id":7},"localId":"93a0ad61-b6a4-46ee-9867-d00c96e0fc36"}},{"type":"extension","attrs":{"extensionKey":"question","extensionType":"com.thinktilt.proforma","layout":"default","parameters":{"id":5},"localId":"452934eb-db25-4c53-a441-00914a60f762"}},{"type":"extension","attrs":{"extensionKey":"question","extensionType":"com.thinktilt.proforma","layout":"default","parameters":{"id":6},"localId":"8cb60a03-30b6-4510-b0ef-e1289807ca46"}}]}]},{"type":"extension","attrs":{"extensionKey":"question","extensionType":"com.thinktilt.proforma","layout":"default","parameters":{"id":8},"localId":"bbaa31b3-6b93-456f-904b-739280109783"}},{"type":"extension","attrs":{"extensionKey":"question","extensionType":"com.thinktilt.proforma","layout":"default","parameters":{"id":19},"localId":"77f5a8b9-1d2d-4fb5-946b-656b001ee870"}}]},{"version":1,"type":"doc","content":[{"type":"heading","attrs":{"level":2},"content":[{"type":"text","text":"2. Detalhes dos registros a serem acessados"}]},{"type":"paragraph","content":[{"type":"text","text":"Para localizar os registros necessários, forneça o máximo de informações possível. Liste o departamento ou serviços dos quais você acessou e dos quais precisa de registros, como, por exemplo, PALs, reclamações, cuidados contínuos de saúde ou Recursos Humanos, etc."}]},{"type":"layoutSection","content":[{"type":"layoutColumn","attrs":{"width":33.33},"content":[{"type":"extension","attrs":{"extensionKey":"question","extensionType":"com.thinktilt.proforma","layout":"default","parameters":{"id":10},"localId":"b420b3fb-7a46-4792-aee0-12e9cb301e7e"}},{"type":"extension","attrs":{"extensionKey":"question","extensionType":"com.thinktilt.proforma","layout":"default","parameters":{"id":11},"localId":"16ff38a9-93ae-4bff-9072-734c1b0bdeff"}},{"type":"extension","attrs":{"extensionKey":"question","extensionType":"com.thinktilt.proforma","layout":"default","parameters":{"id":12},"localId":"9d49c624-bba6-4bf9-948a-a2b675e68a69"}}]},{"type":"layoutColumn","attrs":{"width":66.66},"content":[{"type":"extension","attrs":{"extensionKey":"question","extensionType":"com.thinktilt.proforma","layout":"default","parameters":{"id":13},"localId":"de6d0ad8-d505-453e-b15a-c7a891ae6117"}},{"type":"extension","attrs":{"extensionKey":"question","extensionType":"com.thinktilt.proforma","layout":"default","parameters":{"id":14},"localId":"da10ffa5-fd20-4c72-a942-4ac357cfddec"}},{"type":"extension","attrs":{"extensionKey":"question","extensionType":"com.thinktilt.proforma","layout":"default","parameters":{"id":15},"localId":"11cdff51-d4f7-4556-9084-c555eab8fb8b"}}]}]}]},{"version":1,"type":"doc","content":[{"type":"heading","attrs":{"level":2},"content":[{"type":"text","text":"3.Detalhes do solicitantes"}]},{"type":"paragraph","content":[{"type":"text","text":"(Complete se for diferente dos detalhes de pacientes/clientes/membros)"}]},{"type":"layoutSection","content":[{"type":"layoutColumn","attrs":{"width":50},"content":[{"type":"extension","attrs":{"extensionKey":"question","extensionType":"com.thinktilt.proforma","layout":"default","parameters":{"id":21},"localId":"fc9dd5a4-4302-462a-8193-71946ddc2fc3"}},{"type":"extension","attrs":{"extensionKey":"question","extensionType":"com.thinktilt.proforma","layout":"default","parameters":{"id":22},"localId":"b3252b0d-1856-4d96-84ee-5fbbe2daab17"}},{"type":"extension","attrs":{"extensionKey":"question","extensionType":"com.thinktilt.proforma","layout":"default","parameters":{"id":27},"localId":"4365bb50-9de0-44be-9132-e45c05c05cad"}}]},{"type":"layoutColumn","attrs":{"width":50},"content":[{"type":"extension","attrs":{"extensionKey":"question","extensionType":"com.thinktilt.proforma","layout":"default","parameters":{"id":26},"localId":"70ea51ea-8af5-4ebf-8cd4-eaf75d3f38ca"}},{"type":"extension","attrs":{"extensionKey":"question","extensionType":"com.thinktilt.proforma","layout":"default","parameters":{"id":24},"localId":"aa2dbe65-f8e7-4d04-85da-e51d6bb06973"}}]}]},{"type":"heading","attrs":{"level":3},"content":[{"type":"text","text":"4. Autorização para liberação ao solicitante (a ser preenchida pelo paciente/cliente/membro da equipe, caso não esteja fazendo sua própria solicitação) deve estar no seguinte formato:"}]},{"type":"panel","attrs":{"panelType":"info"},"content":[{"type":"paragraph","content":[{"type":"text","text":"Eu "},{"type":"text","text":"(nome completo do paciente)","marks":[{"type":"strong"}]},{"type":"text","text":" autorizo por meio deste a BRAINCARE DESENVOLVIMENTO E INOVAÇÃO TECNOLÓGICA SA a divulgar quaisquer dados pessoais que possam ter em relação a mim ao solicitante acima mencionado e a quem autorizo a agir em meu nome.\""}]},{"type":"paragraph","content":[]},{"type":"paragraph","content":[{"type":"text","text":"Assinatura do paciente/cliente/membro: ____________________________ Data:"},{"type":"text","text":" ","marks":[{"type":"strong"}]},{"type":"text","text":"/ 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