Chung-Ang University Hospital

Information on collection and use of personal information

You may not agree to the collection and use of personal information below.
In this case, please contact the International Healthcare Center and provide your information.
Required items : First Name, Last Name, Email, Password, Gender, Date of Birth, Nationality, Korean National Health lnsurance, Disease/CheckUp
Selectable items : hone Number, Alien Registration No., Passport No., Language, Country of residence, Using Chung-Ang University Hospital before
Personal information retention period : In accordance with Korean Medical Law standards (can be extended if necessary)

Patient Information
*First Name
*Last Name
Phone Number
*Email
*Password	Use 8-20 characters with at least three character categories - uppercase characters, lowercase characters, numbers, and special characters (~!@#$%^&*).
*Confirm Password
*Gender	MALE FEMALE
*Date of Birth
Alien Registration No.
Passport No.
*Nationality
Language
Country of residence
*Korean National Health lnsurance	YES NO
*
Using Chung-Ang University Hospital before?	YES NO
*Captcha

CHUNG-ANG UNIVERSITY
HOSPITAL