Dr. İsmail Bayram Personal Data Application Form

GENERAL EXPLANATIONS

Your rights

In Article 11 of the Law No. 6698 on the Protection of Personal Data (“Law”), the personal data owners defined as the data subject (hereinafter referred to as the “Applicant”), to learn whether personal data related to them are processed (KVKK 11.1.a), requesting information about personal data, if any (KVKK 11.1.b), learning the purpose of processing personal data and whether it is used for these purposes (KVKK 11.1.c), knowing the third parties to whom personal data is transferred in the country or abroad (KVKK 11.1.ç) , to request correction of personal data if it is incomplete or incorrectly processed (KVKK 11.1.d), to request the deletion or destruction of personal data within the framework of the conditions stipulated in Article 7 of the Law (KVKK 11.1.e), above (d) and (e) Requesting the notification of the transactions made pursuant to the subparagraphs of the paragraphs to the third parties to whom the personal data is transferred (KVKK 11.1.f), objecting to the emergence of a result against the person by analyzing the processed data exclusively through automated systems (KVKK 11.1.g), unlawful processing of personal data Some rights have been granted, such as demanding the compensation of the damage (KVKK 11.1.ğ).

Your requests in this context, Dr. You can send it to İsmail Bayram with the methods and methods explained in detail below. For us to provide faster and more accurate information to your requests and to take more effective action in line with your requests, you can fill in the ready Application Form that we have prepared for you and send it to us.

Under Article 13 of the Law and Article 5 of the Communiqué on the Procedures and Principles of Application to the Data Controller; Applications regarding these rights must be submitted to us in writing in Turkish or by other methods determined by the Personal Data Protection Board (“Board”).

Application Channels

Information on how written applications can be sent to us is given below.

APPLICATION METHOD ADDRESS TO BE MADE IN THE APPLICATION SHIPPING
INFORMATION TO BE SPECIFIED
Written Application
(Personal application of the applicant with a document certifying his identity)

Dikilitaş Mh, Yenigelin Sk, Apt No 25, D. No 1, BEŞİKTAŞ / İSTANBUL On the envelope
“KVKK Information Request”

will be written.

Via Notary Public, Dikilitaş Mh, Yenigelin Sk, Apt No 25, D. No 1, BEŞİKTAŞ / İSTANBUL “KVKK Information Request” in the subject part of the notification.
will be written.

Application Procedure

By the Communiqué on the Procedures and Principles of Application to the Data Controller (OG dated 10/03/2018 and numbered 30356), in your applications (a) your name, surname, and signature, (b) T.R. for citizens of the Republic of Turkey. identification number, nationality for foreigners, passport number or identification number, if any, (c) your place of residence or workplace address for notification, (ç) your notification e-mail address, telephone and fax number, if any, (d) the subject of the request and also the relevant Your information and documents must be attached to the application.

If you are making an application on behalf of someone else, send the documents issued or approved by the competent authorities and showing that you are authorized to apply under the Law (the document showing that you are the parent/guardian of the personal data owner, clearly includes the authority to request within the scope of your data, such as a power of attorney) in the annex of the application.

You can use the Application Form below regarding your data. It reserves the right to request additional documents and information (copy of identity card or driver's license, etc.) for identification and authorization to eliminate legal risks that may arise from illegal and unfair data sharing, and especially to ensure the security of your data. It does not accept any responsibility for the requests originating from the wrong information or unauthorized application in case the information regarding the requests you submit within the scope of the form is not correct and up-to-date or an unauthorized application is made.

Your applications submitted to us will be answered free of charge in writing within thirty days at the latest from the date of receipt of your request, depending on the nature of the request, by paragraph 2 of Article 13 of the Law. However, in cases where a written answer will be given, no fee will be charged for up to ten pages, and a transaction fee (1 TL) determined by the Board will be charged for each page exceeding ten pages.

APPLICATION FORM

Requesting Applicant's
Name and Surname: ………………………………………………

Turkish Identity Number: ………………………………………………

Nationality for Foreigners

and Passport Number: ………………………………………………

Notification Main Workplace

or Residence Address: ……………………………

Notification E-mail Address: ……………………………

Phone Number: ………………………………………………

If applying on behalf of someone else

Descriptions: ………………………………………………

Applicant's Dr. Relationship with İsmail Bayram
Patient
The relatives of the patient
Worker
Business Partner
Former Employee
Website User
Visitor
Reason and time to visit: …………….……………………………………….

……………………………………………………………………………………………..

Other: …………………………………………………………………….………..
…………………………………………………………………………………………….

…………………………………………………………………………………………….

Please specify your request under the Law in detail.
…………………………………………………………………………………………….

…………………………………………………………………………………………….

Other information on the subject and documents you want to add to the Application Form.
…………………………………………………………………………………………….

…………………………………………………………………………………………….

Please choose the method of notifying you of our response to your application.
I want it to be sent by courier to the address I specified below: …………………………………………………………………….…………………….
I want it to be sent by e-mail to the following address: …………………………………………………………………….…………………….
I want to receive it by hand.

In line with the requests I have stated above, Dr. I request that my application made to İsmail Bayram be evaluated by Article 13 of the Law and I would like to be informed.

I declare and undertake that the documents and information I have provided to you in this application are correct and up-to-date and belong to me.

Applicant

Name and Surname

Application Date

Signature