HELP ASSISTANCE IN BENIDORM - COVID-19 EMERGENCY
Form for people who need specific help due to the Emergency Situation COVID-19

From Benidorm we want to facilitate any possible help. We need your information completing this form and we will contact you as soon as possible.
Name *
Your answer
Surname *
Your answer
ID number *
Your answer
Are you in any of the known as RISK GROUPS? (people over 65 years old and / or those who have immune, chronic, cardiac, lung, kidney, liver, blood or metabolic diseases) *
Birthdate *
MM
/
DD
/
YYYY
Adress *
Your answer
Area where you live in Benidorm *
We will use it to facilitate movement by proximity
Telephone number *
Your answer
Email *
Your answer
What time / days you need assistance? *
Your answer
What do you need help for? *
Required
Add any comments that may be useful for us
Your answer
DO YOU ACCEPT OUR PRIVACY POLICY? * At VISIT BENIDORM we process the information that you provide us in order to manage the collaboration request due to the emergency of the COVID-19 reason why this form is created. The data provided will be kept as long as the management of the situation remains. You have the right to obtain confirmation on whether VISIT BENIDORM is treating your personal data and therefore you have the right to access your personal data, change wrong data or request to delete it when the data is no longer necessary, as well as exercise your rights to opposition, portability and limitation in the email address direccion@visitbenidorm.es. Likewise, with the acceptance of the policy privacy, we expressly request your authorization to transfer the data to the entities that for reasons of management / organization / and execution of the situation for the correct development of the situation *
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy