The information on this form is mandatory when the fields are followed by a “*”. This information will be used to process your request. The recipients of the data are: the ORPEA Group, CLINEA, their subsidiaries and the facilities making up the group and located in France. Your data will be kept for a maximum of 6 months from the last contact or after two successive requests without response. Concerning the free text entry fields allowing you to record your comments, the persons concerned by your remarks have a right of access to the information contained in this text zone. The information you enter must be RELEVANT to the context. It must not contain any subjective assessment, nor show, directly or indirectly, the health data, racial origins, political, philosophical or religious opinions, trade union memberships or morals of the persons concerned. In accordance with Regulation (EU) No. 2016/679 of April 27, 2016 and the amended "Informatique et Libertés" French law of January 6, 1978, you have a right of access, rectification, portability, erasure of these or a limitation of processing. In addition, you may object to the processing of data concerning you and have the right to withdraw your consent at any time. If you wish to exercise your rights and obtain information about on how your data is processed, you can contact the ORPEA Group's Data Protection Officer by e-mail at dpo@orpea.net or by post at the following address Délégué à la Protection des Données, Département Protection des Données Groupe ORPEA, Direction de l’Audit, des Risques et du Contrôle Interne, 12 rue Jean Jaurès, CS 10032, 92813 Puteaux Cedex. You have the right to file a complaint with a supervisory authority.