Privacy Notice — Processing of Your Health Data
Kambo Berlin — Health Intake Form prior to your session | As of: May 2026
1. Who is responsible?
Martina Diehn
Kambo Berlin (Gesundheitspraxis Prenzlauer Berg)
Schivelbeiner Str. 31, 10439 Berlin, Germany
Email: martina@kambo.berlin | Phone: +49 170 5034091
No data protection officer has been appointed (not legally required given the scope of processing).
2. What data is collected?
Contact and identification data: Name, age, address, email address, phone number, emergency contact.
Health data (special category under Art. 9 GDPR): Information about pre-existing conditions, medications, substance use disorders, mental health conditions, cardiovascular health, pregnancy, vaccination status, and other health-related circumstances relevant to the conduct of a Kambo session.
3. Purpose and legal basis
Safety screening (assessment of contraindications)
→ Art. 6(1)(a) GDPR + Art. 9(2)(a) GDPR
Communication in connection with your session
→ Art. 6(1)(a) GDPR
Documentation for the establishment, exercise or defence of legal claims
→ Art. 6(1)(f) GDPR
Kambo is not a medical procedure. The collection of this data serves exclusively the safety of the participant and the practitioner — not medical diagnosis or treatment.
4. Retention period
Your data will be retained for 3 years from the date of your last session and then deleted (in accordance with § 195 of the German Civil Code, BGB). In the event of an ongoing legal dispute, data will be retained until the matter is fully resolved.
5. Who receives your data?
Jotform Inc. (data processor): This form is operated via Jotform EU. Jotform processes your data exclusively on our behalf on servers located within the European Union. A data processing agreement pursuant to Art. 28 GDPR is in place.
Your data will not be shared with any other third parties, used for advertising purposes, or transferred to third countries.
6. Your rights
You have the right at any time to:
- Access (Art. 15 GDPR)
- Rectification (Art. 16 GDPR)
- Erasure (Art. 17 GDPR)
- Restriction of processing (Art. 18 GDPR)
- Data portability (Art. 20 GDPR)
- Object to processing (Art. 21 GDPR)
- Withdraw your consent (Art. 7(3) GDPR) — at any time with effect for the future, without giving reasons
Requests: martina@kambo.berlin
Competent supervisory authority:
Berliner Beauftragte für Datenschutz und Informationsfreiheit
Friedrichstr. 219, 10969 Berlin, Germany
mailbox@datenschutz-berlin.de
