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Sardegna Sicura - Decree of the President of the Region n.27 of 02/06/2020
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Ordinance of the President of the Region n.27 of 02/06/2020 - REGISTRATION

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* Fields marked with an asterisk are mandatory

General data

Name*

Surname*

Gender*

Italian nationality

Tax Code*

Nationality*

Birthplace*

Day of birth*

Resident in Sardinia*

City of residence*

Province of residence*

Street/Avenue/Square*

Street Number*

Post Code*

Phone Number*

Email Address*

Confirm Email Address*

Dependent minors

Specify if there are dependent minors. If the minors are travelling with both parents, they must be registered only as dependent of one of the two.

Arrival registration

Data of origin

Country of origin:*

City of origin:*

Date of arrival in Sardinia*

At*

Means of transport*

Number of flight/name of ship/Ticket number:

Operated by the Company:*

The name of the accomodation is mandatory, only if the type of accomodation is an Hotel, Other accomodation or Other

Data about the stay (specify at least a accomodation)

Type of accomodation*

Name of the accomodation

Location*

Address*

Check-in Date*

Delete

Add accomodation

Departure from Sardinia

No departure date from Sardinia is planned or known

Departure boarding data

Departure date*

At*

Means of transport*

Number of flight/name of ship/Ticket number:

Operated by the company:*

Data of destination

Country of destination:*

City of destination:*

Details of the identity document and attachments

Enter the details of the document that you will show on boarding

Type of document*

Document number*

Insert any attachments (not mandatory)

Attach a file (accepted formats: pdf, jpg, png, gif, jpeg, doc, docx, pub, xps, mp4, zip)

Attach other files (accepted formats: pdf, jpg, png, gif, jpeg, doc, docx, pub, xps, mp4, zip)

MEDICAL HISTORY

Did you have one or more of these symptoms in the last 21 days?

Fever > 37,5 °C (99,5 °F)*

Cough*

Fatigue*

Sore throat*

Headache*

Muscle pain*

Congestion*

Nausea*

Vomiting*

Loss of sense of smell or taste*

Conjunctivitis*

Diarrhoea*

EPIDEMIOLOGICAL DATA

Please communicate anything in your knowledge

Exposure to confirmed COVID-19 cases*

Exposure to suspected COVID-19 cases*

Personal contact with relatives of suspected COVID-19 cases*

Cohabitants with fever or flu-like symptoms*

Personal contact with other people with fever or flu-like symptoms*

Did you travel in the last 40 days?*

Region/s*

Nation/s*

DECLARES UNDER HIS/HER OWN RESPONSIBILITY

The undersigned, as identified above, declares under their own responsibility that the personal data and the data related to the travel and stay in Sardinia are true, aware of the civil and criminal consequences of false declaration;

The undersigned undertakes to immediately communicate to the Competent Health Authorities the occurrence of the disease, on oneself or the children upon whom exercise parental responsibility, (of) any symptoms among those described in the following form: Civil Protection hotline: 800 894 530, Health Department hotline: 800 311 377

The undersigned agrees to be tested with a diagnostic virological test for COVID-19, at the occurrence of clinical manifestations that are compatible with an ongoing infection.

I, the undersigned authorise the processing of my personal data also through an IT application, bearing in mind that my personal data will be entered in a specific regional database, stored for 14 days and used for the monitoring activity of the data subjects, as provided by art. 5 of ordinance No. 27 of June 2, 2020

The undersigned agrees to respect all the preventive measures (wearing face masks and social distancing) as by national and regional guidelines, as well as those implemented in the accomodation in which the undersigned will be staying.

Information on the processing of personal data

The following informative report is presented in a simplified form.

The owner of treatment is the Autonomous Region of Sardinia that processes the personal data provided by filling out the registration form.

In particular, the data can be transmitted to public and private entities involved in the emergency management, as referred to in article 17 bis of the L.D. n. 18/2020, in those cases in which it will be essential to preserve the purpose of the related activities connected to the management of the emergency.

In accordance with article 5 of the Decree of the President of the Region, n. 27 of 02/06/2020, the names and addresses acquired.

The data controller gives notice that the personal data acquired will be stored in the regional data centre.

Contact details of the data controller:

Autonomous Region of Sardinia:

Viale Trento 69 – 09123 Cagliari

Phone Number +39 070 6067000

e-mail presidente@regione.sardegna.it

PEC presidenza@pec.regione.sardegna.it

Contact details of the Data Protection Officer of the Autonomous Region of Sardinia:

Viale Trieste 186 – 09123 Cagliari

Phone Number +39 070 6065735

e-mail rpd@regione.sardegna.it

PEC rpd@pec.regione.sardegna.it

The rights provided for in Articles 15 to 23 of Regulation(EU) 2016/679, including the right of access to one's own data, retification, erasure, can be exercised in the following ways:

e-mail presidente@regione.sardegna.it

e-mail rpd@regione.sardegna.it

PEC presidenza@pec.regione.sardegna.it

PEC rpd@pec.regione.sardegna.it

By filling in the form available at the following link:

Form for exercising the rights of the data subjects

Further requests for clarification must be sent only to the appointed email address urp.emergenza@regione.sardegna.it

Acknowledgement

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Ordinance of the President of the Region n.27 of 02/06/2020 - REGISTRATION