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Medical Registration | Sharon Comrie Training and Team Empowered


    The Scanner is a measuring tool, for use in determining whether to increase a person’s intake of certain selected dietary ingredients, specifically carotenoids. The information derived from the measurement obtained from the Scanner is to be considered only as a part of an overall, well rounded approach to good health practices, including regular monitoring of certain dietary intakes and is not intended to provide an overall nutritional profile.
    By signing this form, you consent to the processing of the results of your scan, i.e. your carotenoid level, as well as the additional information submitted by you, which may include information such as your name, email, gender, height and consumption habit (the “Personal Data”). Nu Skin International Inc. will process your Personal Data at its corporate headquarters in the United States (75 West Center Street, Provo, Utah 84601, USA.) in the name and on behalf of the Scanner Operator. Your Personal Data is being processed for the purpose of providing you with the requested products and services or for statistical research
    purposes.

    NAME*

    DATE*

    SIGNATURE

    Consent to receiving communications from the company and your scanner operator:

    YESNO

    You understand that Nu Skin International Inc. is located outside the European Union and hereby consent to the transfer of your Personal Data to the United States of America. This transfer is based on an adequacy decision and/or on standard data protection clauses of the European Commission.
    Nu Skin International Inc. operates secure data networks protected by industry standard firewall and
    password protection systems. Nu Skin also uses transport layer security (TLS) to protect the transmission of your data. Access to this information will be provided only to authorized individuals for legitimate business purpose.
    We will not retain the personal data any longer than necessary to pursue the purposes for the processing of your personal data.
    As a data subject in the European Economic Area, you have the right to request, access, rectify, erase, and restrict how your Personal Data is being processed. These rights include the ability to review the Personal Data we have in our information and communications systems concerning you, the ability to make any corrections to that Personal Data, the ability to be informed of who that Personal Data may have been shared with, the ability to request that we erase all of your Personal Data, and the ability to restrict how we Process your Personal Data.
    We will respond to any of your requests to exercise these above data subject rights within one month. We reserve the right to extend that period by two further months where necessary, taking into account the complexity and number of the requests we receive from you.
    You may also withdraw your consent for the processing of Personal Data, to the extent that the processing of your Personal Data was solely based upon such consent.

    If you want to exercise your rights, you may contact Nu Skin International Inc. or our privacy point of contact at:
    Organization Data Protection Officer Nu Skin International Inc. 75 West Center Street, Provo, 84601 Utah USA +1 (801) 345-1505 privacy@nuskin.com
    Mark Milne 75 West Center Street, Provo, 84601 Utah USA +1 (801) 345-1505 privacy@nuskin.com

    If you would like to lodge a complaint against us, you may contact your local supervisory authority. If you have trouble locating a supervisory authority, please contact Mark Milne above to help you contact a supervisory authority.
    To comply with GDPR regulations and to help you please complete the following questionnaire to enable me to collate information regarding your health and wellbeing.

    Telephone No:

    Age group:

    18-2526-3536-4041-5051-60over 60

    Email address:

    Do you get tired often?

    YesNo

    Occupation:

    Do you suffer colds\ flu’s often?

    YesNo

    Usual daily stress level on a scale of 1-10 (1 being low):

    12345678910

    Do you take supplements?

    YesNo

    How many hours sleep do you have per night?

    Average water intake per day (in litres):

    Are you on any medication?

    YesNo

    Are you a smoker?

    YesNo

    Average portions of fruit and vegetables consumed in one day:

    Have you had any big stress situations in the last 3 months:

    YesNo

    Average alcohol intake per week:

    Reason for scan:

    Weekly physical activities (walking, running etc):

    Scan score:

    Changes you will take before your next scan in 4-6 weeks:

    Scanner Operators Name:

    Scanner Operators Email:


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