GENERAL EXPLANATIONS:

It is regulated that personal data owners ("Data Owner") defined as relevant persons in the Personal Data Protection Law No. 6698 ("Law") can exercise the rights granted in Article 11 of the Law regarding their personal data and must apply to the Data Controller to exercise these rights. .

In accordance with the 1st paragraph of Article 13 of the Law; OP as data controller. DR. Applications regarding these rights to be made to DENİZ KORKMAZ (“Data Controller” or “Organization”) must be submitted to us in writing or by other methods determined by the Personal Data Protection Board (“Board”).

APPLICATION WAY:

In this context, applications to be made to our organization in "written" form;

By personally submitting a signed copy of this Application Form, which has been completed in full, along with a document that will provide identification, to the address Zühtüpaşa Mah Münir Nurettin Selçuk Cd No:70 Kalamış Park Apt D:2 Kalamış, 34724 Kadıköy/İstanbul,

A copy of this fully completed Application Form, with a wet signature, along with a document that will enable identification, must be forwarded to us by sending it to the same address via a notary.

The channels mentioned above are "written" application channels in accordance with the first paragraph of Article 13 of the Law. After the other methods determined by the Board are announced, our organization will announce how applications will be received through these methods.

Your applications submitted to us will be answered free of charge "as soon as possible and within thirty days at the latest" from the date your request reaches us, depending on the nature of the request, in accordance with the 2nd paragraph of Article 13 of the Law. However, if the transaction requires an additional cost, our organization will charge the fee at the tariff determined by the Personal Data Protection Board. Our answers will be delivered to you in writing or electronically in accordance with the provision of Article 13 of the relevant Law.

Depending on the nature of this form and your request, the information and documents requested from you must be provided to us completely and accurately. If the requested information and documents are not provided as required, there may be disruptions in the complete and qualified conduct of the research to be carried out by our organization based on your request. In this case, our organization declares that it reserves its legal rights. For this reason, the relevant form must be sent completely and containing the requested information and documents, depending on the nature of your request.

IDENTIFICATION OF THE APPLICANT AND CONTACT INFORMATION REGARDING HIS APPLICATION

The following information must be provided so that we can identify the "applicant" regarding your application and conduct the necessary research within our organization depending on the nature of your request.

In addition, your contact information specified below is requested in order to obtain more detailed information about your application, to inform you about our review processes and to convey the results of your application to you.

Name Surname :

TR Identity Number :

Date of Birth :

E-mail :

(if you specify, we will be able to respond to you faster)

In order to ensure the security of your personal data, within seven (7) days from the date of receipt of your application for obtaining information, our Organization may contact you to confirm that you are the data subject and may request some information and documents from you in this regard.

In case the requested information and documents are incomplete, the information and documents will need to be completed and submitted to us upon our request. The thirty (30) day period specified in Article 13/2 of the Law regarding the finalization of the request will be suspended until the information and documents are fully submitted to us.

Please indicate your relationship with our organization (e.g. patient, business partner, prospective employee, former employee, third party company employee, shareholder)

Patient Visitor

☐ Business partner/Staff ☐ Other .......................

You have been interviewed within our organization. Unit/Person:..................................................................................................................................................... Subject: .........................................................................................................................................................

☐ Former Employee Years You Worked : .................. ☐ Other ......................................................

I Made a Job Application / Resume Sharing. Date : ........... Third Party Company Employee Please provide your company and position informationspecify

Please explain your request under the Law in detail:

.............................................................................................................................................................................................

.............................................................................................................................................................................................

Please select the method by which you will be notified of our response to your application:

I want it sent to my address.

I want it sent to my e-mail or KEP address.

(We will be able to respond to you faster if you choose the e-mail method).

Demand No	Request Subject	Your choice
1	To learn whether your organization processes personal data about me I want to.
2	If your organization processes personal data about me, I request information about these data processing activities. Article 11/1 (b) of the Law on the Protection of Personal Data
3	If your organization processes personal data about me, I would like to learn the purpose of processing and whether it is used in accordance with the purpose of processing. Article 11/1 (c) of the Law on the Protection of Personal Data
4	If my personal data is transferred to third parties at home or abroad, I would like to know these third parties. Article 11/1 (ç) of the Law on the Protection of Personal Data
5	I believe that my personal data is incomplete or incorrectly processed and I would like them to be corrected. Please write the personal data you want to be corrected in the "Your Choice" field and send the documents showing the correct and complementary information as an attachment. (Photocopy of identity card, residence, etc.) Article 11/1 (d) of the Law on the Protection of Personal Data	Data to be corrected;
6	Although my personal data has been processed in accordance with the provisions of the law and other relevant laws, I believe that the reasons requiring its processing have disappeared and within this framework, I request that my personal data; a) be deleted. b) I request anonymization. Article 11/1 (e) of the Law on the Protection of Personal Data	Only one box can be checked. a) b)
7	I want my personal data (Request No. 5), which I think is incomplete and incorrectly processed, to be corrected by third parties to whom it has been transferred. Please write the personal data you want to be corrected in the "Your Choice" field and send the documents showing the correct and complementary information as an attachment. (Photocopy of identity card, residence, etc.) Article 11/1 (f) of the Law on the Protection of Personal Data	Data to be corrected;
8	Although my personal data has been processed in accordance with the provisions of the law and other relevant laws, I believe that the reasons requiring its processing have disappeared (Request No. 6) and within this framework, I request that my personal data be ; a) I request it to be deleted. b) I request anonymization.	Only one box can be checked. a) b)
9	I believe that my personal data processed by your organization has been analyzed exclusively through automated systems and that as a result of this analysis, a result has arisen against me. I object to this result. Please write the result of the analysis that you think is against you in the "Your Choice" field and send the documents supporting your objection as an attachment. Article 11/1 (g) of the Law on the Protection of Personal Data	Data Resulting from the Analysis;
10	I have suffered damage due to unlawful processing of my personal data. I request compensation for this damage. Please write the matter subject to the violation of the law in the "Your Choice" field and attach the supporting documents (Court decision, Board decision, documents showing the amount of material damage, etc.) Article 11/1 (h) of the Law on the Protection of Personal Data	Matter Subject to Violation of the Law;

In line with the requests I have stated below, I kindly request that my application to your organization be evaluated in accordance with Article 13 of the Law and that I be informed. Name Surname : Application Date : Signature :