"The information provided on this form concerning you is for the use of our establishment and our technical service providers in order to process your request. You accept our privacy policy for personal data. In accordance with Law No. 78-17 of January 6, 1978, as amended, and the General Data Protection Regulation, you have the right to access, rectify, erase, oppose, and limit the processing of personal data concerning you, as well as the right to data portability and to define your directives regarding the management of your data after your death. You can exercise these rights by email at the address . For more information, please refer to the legal notice.