대한민국 대표 성장클리닉 서정한의원

Inquiry form Filling in the inquiry form with student and parents

プライバシ?ポリシ?
Your personal information will not disclosed, we comply with the laws regarding, the promotion of information, communication network use and protection of information. Seojung Eastern Medicine Clinic informs users on how we protect provided personal information. If there are material changes to this policy in the future, information concerning any such change will be posted on this webpage ■ Collection of personal information Seojung Eastern Medicine Clinic acquire personal information for registration, the responding inquiries, and applying of medical service, etc. ◎ List of personal information - name, date of birth, sex, address, telephone number, cellphone number, e-mail, access log, cookies, IP address ◎ Method of collection for personal information -homepage (member registration, message board, service application, etc.) ■ Handling of personal information for non-membership ◎ As for non-membership, Seojung Eastern Medicine Clinic requests personal information to a minimum extent to respond to inquiries and to provide information of medical treatment. Only relevant information is used and protected. ◎ We protect personal information of non-membership as same as level of membership. ■ Collection and Purpose of use of Personal Information Seojung Eastern Medicine Clinic shall use collected personal information for the following purposes. ◎ Fulfill the contract according to provided service and the payment for the selected service. ◎ Management of membership ? confirming of identity as using service of membership, prevention of use of unjustifiable users, confirming of intention of register, confirmation of age, any complaints about your membership will be addressed by our personal information’s officer, If any suspicious activity occurs on your account we will shortly, notify you. ◎ Use of marketing and advertisement: development and specialization of new products, sending advertising information (events etc.), provision of service and posting advertisement according to the targeted demographic. ■ Reading and Correction of Personal Information ◎ Subscribers may at any time read and correct their registered information. When you want to read and correct personal information, you may click “change of subscriber information”, or please notify us about the necessary changes via written letter, telephone or e-mail. Our staff will then make the appropriate changes. ◎ Do not utilize your personal information until the necessary changes have been made. ◎ If we already provided third party with false personal information, we would notify third party promptly and correct. ◎ Seojung Eastern Medicine Clinic may at any time erase your personal information upon request by a user or legal representative through the “Period of Retention and Use” policies which prevents your personal information to be disclosed to any other users. ■ Withdrawing consent about collection, use, and provision of personal information ◎ You may at any time withdraw your consent about the collection, use, and provision of personal information. You may click "withdraw membership” or please notice via written letter, telephone or e-mail to our personal information management officer. We will then take affirmative action upon receiving your withdrawal and update you or your membership status. ◎ Seojung Eastern Medicine Clinic will take appropriate action in order to withdraw consent about collection of personal information easily more than collecting personal information. ■ Period of Retention and Use of Personal Information We will maintain and protect personal information during the provision of our services, we will immediately erase your personal information after obtaining your consent of withdrawal. ◎ The case of registration ? We will retain your personal information until withdrawal or in special cases expulsion. ◎ The case of collection for survey, event, etc. for a temporary purpose - Upon completing survey, event, etc., we will retain this information for three years ◎ the case of collection for consultation or provision of medical service - Upon completing response to the counseling or medical service , we will retain this information for three years ■ Procedure and method of eradicating personal information In principle, Seojung Eastern Medicine Clinic immediately erases personal information after obtaining consent of withdrawal. The eradication procedures are the following; ◎ Eradication procedure The information that subscribers enters to the registry will be moved to a separate DB(Data Base)(for paper: separate filing cabinet), we will keep your personal information for a certain period of time according to the clinic's internal guidelines and related laws of information protection (Reference-period of retention and use) The information that is moved to a separate DB is not used except for the retention, unless other laws stipulate to do so. ◎ Method of Eradication Personal information on an electronic file is eradicated irreversibly by through our file system. ■ Provision of Personal Information Seojung Eastern Medicine Clinic will not provide your personal information to any external organization’s except for. ◎ The case that we have your consent ◎ The case under the provision of laws or judicial bodies require personal information in order to investigate by law or legal process. ■ Entrust of collected personal information We will not disclose your personal information to any external organizations unless we have your consent or are required by law or have previously informed you. ■ Automatic personal information collection system Seojung Eastern Medicine Clinic uses cookies to frequently save your information for future use. Cookies are pieces of data stored on a user’s hard drive which are sent by our server for operation. We use cookies for the following purposes: ▶ The Purpose of the Use of Cookies ◎ For analyzing the frequency of visitation’s of the site and to understanding the user’s interests which will create a more personalized service. ◎ You may change the setting of the cookies to your own personal preferences. Thus, you can instruct your browser, by changing its options, to accept all the cookies on your browser, or to prompt you before accepting a cookie from the websites you visit, or to stop accepting cookie on your browser. ▶ Method of disabling the cookies ◎ ex)Regarding the method of disabling the cookies , you can instruct your browser, by changing its options, to accept browser all the cookies, or to prompt you before accepting a cookie from the websites you visit , or to stop accepting browser all the cookies ◎ The Cookies setting (ex.internet explorer) Menu on Browser>Internet Options> Personal Information, but there might be service interruption if you decide to disable the cookies. ■ Complaints of Personal Information Seojung eastern medicine clinic designates following division and personal information management officer to protect personal information and to deal with complaints ◎ Relevant department : marketing ◎ Tel : 82-2-515-8573 ◎ E-mail : rabbit337@sjaymedience.com ◎ name of personal information management officer : Park Ji sun ◎ Tel : 82-2-515-8573 ◎ E-mail : rabbit337@sjaymedience.com All complaints concerning the protection of personal information while using the services of Seojung Eastern Medicine Clinic should be addressed to the Personal Information Management Officer or Relevant Department. Seojung Eastern Medicine Clinic will respond to your complaints quickly and effectively. If you have any inquiries or complaints, please contact the following organizations: 1. Personal Dispute Mediation Committee (www.1336.or.kr/1336) 2. The committee of Information Security Mark Certification (www.eprivacy.or.kr/02-580-0533~4) 3. Supreme (Public) Prosecutors' Office internet criminal investigation center (http://icic.sppo.go.kr/02-3480-3600) 4. national police agency cyber terror response center (www.ctrc.go.kr/02-392-0330) ■ Duty of Disclosure ◎ Changes in governmental policies that shall affect the protection and company policies will be posted on notice boards in the Seojung Eastern Medicine Clinic, seven days before the changes have been made. ◎ Personal Information Management Policy is applied since July 1, 2010, the formal Personal Information Management Policy is replaced with new one. Consent to the Personal information management policy
Agree

プライバシ?ポリシ?

Your personal information will not disclosed, we comply with the laws regarding, the promotion of information, communication network use and protection of information.
Seojung Eastern Medicine Clinic informs users on how we protect provided personal information.
If there are material changes to this policy in the future, information concerning any such change will be posted on this webpage

■ Collection of personal information  
Seojung Eastern Medicine Clinic acquire personal information for registration, the responding inquiries, and applying of medical service, etc.
◎ List of personal information - name, date of birth, sex, address, telephone number, cellphone number, e-mail, access log, cookies, IP address
◎ Method of collection for personal information -homepage (member registration, message board, service application, etc.)

■ Handling of personal information for non-membership 
◎ As for non-membership, Seojung Eastern Medicine Clinic requests personal information to a minimum extent to respond to inquiries and to provide information of medical treatment. Only relevant information is used and protected.
◎ We protect personal information of non-membership as same as level of membership.

■ Collection and Purpose of use of Personal Information
Seojung Eastern Medicine Clinic shall use collected personal information for the following purposes. 
◎ Fulfill the contract according to provided service and the payment for the selected service.
◎ Management of membership ? confirming of identity as using service of membership, prevention of use of unjustifiable users, confirming of intention of register, confirmation of age, any complaints about your membership will be addressed by our personal information’s officer, If any suspicious activity occurs on your account we will shortly, notify you.
◎ Use of marketing and advertisement: development and specialization of new products, sending advertising information (events etc.), provision of service and posting advertisement according to the targeted demographic.

■ Reading and Correction of Personal Information
◎ Subscribers may at any time read and correct their registered information. When you want to read and correct personal information, you may click “change of subscriber information”, or please notify us about the necessary changes via written letter, telephone or e-mail. Our staff will then make the appropriate changes. 
◎ Do not utilize your personal information until the necessary changes have been made. 
◎ If we already provided third party with false personal information, we would notify third party promptly and correct. 
◎ Seojung Eastern Medicine Clinic may at any time erase your personal information upon request by a user or legal representative through the “Period of Retention and Use” policies which prevents your personal information to be disclosed to any other users.

■ Withdrawing consent about collection, use, and provision of personal information 
◎ You may at any time withdraw your consent about the collection, use, and provision of personal information. You may click "withdraw membership” or please notice via written letter, telephone or e-mail to our personal information management officer. We will then take affirmative action upon receiving your withdrawal and update you or your membership status. 
◎ Seojung Eastern Medicine Clinic will take appropriate action in order to withdraw consent about collection of personal information easily more than collecting personal information.

■ Period of Retention and Use of Personal Information
We will maintain and protect personal information during the provision of our services, we will immediately erase your personal information after obtaining your consent of withdrawal.
◎ The case of registration ? We will retain your personal information until withdrawal or in special cases expulsion.
◎ The case of collection for survey, event, etc. for a temporary purpose - Upon completing                                                      survey, event, etc., we will retain this information for three years 
◎ the case of collection for consultation or provision of medical service - Upon completing response to the counseling or medical service , we will retain this information for three years

■ Procedure and method of eradicating personal information
In principle, Seojung Eastern Medicine Clinic immediately erases personal information after obtaining consent of withdrawal. 
The eradication procedures are the following;
◎ Eradication procedure
The information that subscribers enters to the registry will be moved to a separate DB(Data Base)(for paper: separate filing cabinet), we will keep your personal information for a certain period of time according to the clinic's internal guidelines and related laws of information protection (Reference-period of retention and use)
The information that is moved to a separate DB is not used except for the retention, unless other laws stipulate to do so.
◎ Method of Eradication 
Personal information on an electronic file is eradicated irreversibly by through our file system.

■ Provision of Personal Information  
Seojung Eastern Medicine Clinic will not provide your personal information to any external organization’s except for.
◎ The case that we have your consent 
◎ The case under the provision of laws or judicial bodies require personal information in order to investigate by law or legal process.

■ Entrust of collected personal information
We will not disclose your personal information to any external organizations unless we have your consent or are required by law or have previously informed you.

■ Automatic personal information collection system
Seojung Eastern Medicine Clinic uses cookies to frequently save your information for future use. 
Cookies are pieces of data stored on a user’s hard drive which are sent by our server for operation. We use cookies for the following purposes:

▶ The Purpose of the Use of Cookies
◎ For analyzing the frequency of visitation’s of the site and to understanding the user’s interests which will create a more personalized service.
◎ You may change the setting of the cookies to your own personal preferences. Thus, you can instruct your browser, by changing its options, to accept all the cookies on your browser, or to prompt you before accepting a cookie from the websites you visit, or to stop accepting cookie on your browser.

▶ Method of disabling the cookies 
◎ ex)Regarding the method of disabling the cookies , you can instruct your browser, by changing its options, to accept browser all the cookies, or to prompt you before accepting a cookie from the websites  you visit , or to stop  accepting browser all the cookies
◎ The Cookies setting (ex.internet explorer) Menu on Browser>Internet Options> Personal Information, but there might be service interruption if you decide to disable the cookies.

■ Complaints of Personal Information
Seojung eastern medicine clinic designates following division and personal information management officer to protect personal information and to deal with complaints

◎ Relevant department : marketing
◎ Tel : 82-2-515-8573 
◎ E-mail : rabbit337@sjaymedience.com

◎ name of personal information management officer : Park Ji sun
◎ Tel : 82-2-515-8573 
◎ E-mail : rabbit337@sjaymedience.com

All complaints concerning the protection of personal information while using the services of Seojung Eastern Medicine Clinic should be addressed to the Personal Information Management Officer or Relevant Department. 
Seojung Eastern Medicine Clinic will respond to your complaints quickly and effectively.
If you have any inquiries or complaints, please contact the following organizations:

1. Personal Dispute Mediation Committee (www.1336.or.kr/1336)
2. The committee of Information Security Mark Certification  
(www.eprivacy.or.kr/02-580-0533~4)
3. Supreme (Public) Prosecutors' Office internet criminal investigation center 
(http://icic.sppo.go.kr/02-3480-3600)
4. national police agency cyber terror response center 
(www.ctrc.go.kr/02-392-0330)

■ Duty of Disclosure
◎ Changes in governmental policies that shall affect the protection and company policies will be posted on notice boards in the Seojung Eastern Medicine Clinic, seven days before the changes have been made. 
◎ Personal Information Management Policy is applied since July 1, 2010, the formal Personal Information Management Policy is replaced with new one.

Consent to the Personal information management policy

Agree

Basic Information
お名前
性別(男,女)	男女
生年月日	年月日
?年	?年
連絡先
ケ?タイ番?(?親)
住所
?生の身長	cm
?生の?重	kg
お父さんの身長	cm
お母さんの身長	cm
することができ筋骨フィルムアップロ?ド

Sleep
30分以?にすぐ?れますか？	はい時? いいえ
睡眠時間は7時間以上ですか？	はい時? いいえ
?て起きるときすっきりしますか？	はいまあまあいいえ
睡眠中よく夢をみますか？	はい時? はい

Exercise
規則的に決まっている運動をしますか？	はい時? いいえ
“はい”と答えた人は運動量はどうですか？	30分以? 1時間以上
よくする運動は何でしょうか?

Meal
最近食欲がいい。	はい普通食欲がない
牛乳は一日500CC(小さいコップ二杯)以上?む。	はい時? あまり?まない
乳製品（チ?ズ）は一日一回以上食べる。	はい時? あまり?まない
煮干しを一日一回以上食べる。	はい時? あまり?まない
豚肉、牛肉など肉を一日一回以上食べる。	はい時? あまり?まない
お魚は一週間の中で3～4回以上食べる。	はい時? あまり?まない
卵は一週間の中で3～4回以上食べる。	はい時? あまり?まない
朝ご飯はちゃんと食べる。	食べる時? 食べない
好き嫌いをする。	はい? 약간? いいえ
?る2時間前は食べない。	はい? 약간? いいえ
インスタント食品を一週間の中で3～4回以上食べる。	いいえ時? よく食べる
コ?ラ?と炭酸ジュ?スを一日一回以上?む。	いいえ時? よく?む

Etc
下痢、便秘がある。	いいえ / はい ( 便秘下痢)
よく腹のもたれ?味やガスがたまる。	いいえ? はい
よく消化ができない。	いいえ? はい
鼻がよく詰まる。	いいえ? はい
熱がでなくても咳が出る。	いいえ? はい
風邪によくひく、風邪にひいて治らない。	いいえ? はい
扁桃炎、咽喉炎、中耳炎などにかかる。	いいえ? はい
鼻血がよく出る。	いいえ? はい
よく?んで手や足をひねる。	いいえ? はい
部分的に筋肉が痙攣をおこす。	いいえ? はい
?小便をするか、また尿を漏らす。	いいえ? はい
たまに尿が濁っている。	いいえ? はい
朝起きると?が腫れる。	いいえ? はい ( 手足目)
目眩む。	いいえ? 時?? よく
頭痛がある。	いいえ? はい
現在、患っている病?が有りましたら病名を書いて下さい。

Please complete the following questions, only if you are a middle school student or older.
不安で胸がどきどきするか、よくびっくりする。	いいえ? はい
首の後ろが痛い、目がよく疲れる。	いいえ? はい

Female students only
生理が始まった時期は？
生理痛がある。	いいえ / はい ( 腰お腹胸 )
こしけがある。	いいえはい
手足、またお腹が冷える。	いいえはい

Additional items (Write notes please)

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