APPLICATION UNDER THE LAW ON THE PROTECTION OF PERSONAL DATA

Individuals defined as the data subject in the Personal Data Protection Law No. 6698 (hereinafter Law) are granted certain rights regarding the processing of their personal data in Article 11 of the Law. Pursuant to paragraph 1 of Article 13 of the Law; Applications to be made to İlker Koçak (Hereinafter Data Controller or Clinic), regarding these rights must be submitted to us in writing or by other methods determined by the Personal Data Protection Board (Hereinafter “Board”). In this context, applications to be made to our clinic in written form must be printed out and submitted to us by the applicant's personal application or through a notary public or by signing with the "secure electronic signature" defined in the Electronic Signature Law No. 5070, via the e-mail address specified below. Information regarding how written applications will be delivered to us, specific to the written application channels, is provided below.

Application MethodAddress to applyInformation to be Specified in the Application Submission
Personal ApplicationAtaköy 7-8-9-10. Kısım Mah. Çobançeşme E5 yanyol Cad. Ataköy Towers B Blok Daire : 162 Bakırköy / İstanbul / Türkiye"Information Request Under the Law on Protection of Personal Data" will be written on the envelope.
Notary public noticeAtaköy 7-8-9-10. Kısım Mah. Çobançeşme E5 yanyol Cad. Ataköy Towers B Blok Daire : 162 Bakırköy / İstanbul / Türkiye"Information Request Under the Law on Protection of Personal Data" will be written on the envelope.
Secure Electronic Signature[email protected]"Information Request Under the Law on Protection of Personal Data" will be written in the subject line of the e-mail.

Applications submitted to us will be answered within maximum thirty (30) days from the date of receipt of the request by one of the methods specified above, according to the content of the request, in accordance with the second paragraph of Article 13 of the Law. Our answers will be delivered to the applicant in writing or electronically in accordance with the Article 13 of the relevant Law. According to the "Regulation on Procedures and Principles of Application to the Data Controller" published by the Board in case the request requires additional costs; 1 Turkish Lira transaction fee for each page over ten pages; If the response to the application is given in a recording medium such as CD, flash memory, the fee that may be requested by the data controller will be requested in a way that does not exceed the cost of the recording medium.

I. Information on the recognition of the applicant and how to contact the applicant about the application

Name - Surname :

National ID Number / Passport Number :

Address :

Mobile Phone Number :

E-Mail Address :

II. Disclosures regarding your relationship with our Clinic (such as candidate, employee, supplier, customer, visitor etc.):

III. Please specify in detail your request under the Personal Data Protection Law, the type of data you want to receive information about, the method of transfer, the business process:

IV. Please choose the method of notifying you of our response to your application.

I want it sent to my address.
I want it sent to my e-mail address.
I want to receive it by hand. (In case of receipt by power of attorney, a notarized power of attorney or authorization document is required.)

V. Explanations: This application form has been prepared in order to determine your relationship with our Clinic and to fully determine your personal data, if any, and to respond to your application in a correct and legal time. Our Clinic reserves the right to request additional documents and information (copy of identity card or driver's license, etc.) for determination of identification and authorization, in order to eliminate legal risks that may arise from illegal and unfair data sharing and especially to ensure the security of your personal data. In the event that the information regarding your requests you submit within the scope of the form is not correct and/or out of date, and/or an unauthorized application is made, our Clinic shall not be responsible for such incorrect information or requests arising from unauthorized applications. Your personal data that you share in this form will be processed for the purposes of evaluating and finalizing your request within the scope of the Law, managing the entire process and contacting you for these purposes. Your request may be transferred to our legal consultants, our business partners and service providers providing services in the field of complaint management, quality control, auditing and risk analysis, legally authorized public institutions and private individuals, depending on the nature of the request.

VI. Declaration: I request that the application I have made pursuant to the Personal Data Protection Law be finalized within the framework I have stated above. I accept, declare and undertake that the information and documents I have specified in this form are correct, current and belong to me.

Name - Surname :

Date :

Signature :

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