Personal Data Protection Law Application Form
Information Regarding Your Right to Apply
According to Article 11 of the Personal Data Protection Law No. 6698 (“Law No. 6698”), as a data owner, you can apply to Uzm. Dr. Mezihat BEYOĞLU and make the following requests:
- To learn whether your personal data has been processed,
- If your personal data has been processed, to request information regarding it,
- To learn the purpose of processing your personal data and whether it is being used in accordance with that purpose,
- To learn the third parties to whom your personal data has been transferred, whether domestically or internationally,
- In case your personal data has been processed incompletely or incorrectly, to request its correction and to request that the operation performed in this context be communicated to the third parties to whom the personal data has been transferred,
- To request the deletion, destruction, or anonymization of your personal data, if the reasons for its processing have ceased to exist, even though it has been processed in accordance with the Law No. 6698 and relevant provisions of other laws, and to request that the operation performed in this context be communicated to the third parties to whom the personal data has been transferred,
- To object to a result arising against you, solely by analyzing your processed data through automated systems,
- To request compensation for damages incurred due to unlawful processing of your personal data.
As a data owner, in accordance with the 13th article of the Personal Data Protection Law and the 5th article of the Communiqué on the Procedures and Principles for Applications to the Data Controller, you can submit your application in person or by registered mail to the address “Öğretmenevleri Mah. 922. Sok. No:1 Bilgin Duran Plaza K: 2 D: 21-22 Konyaaltı/Antalya,” by appropriately filling out the information below and attaching documents that verify your identity.
Your application will be concluded as soon as possible, depending on the nature of the request, and at the latest within thirty (30) days from the date it reaches us.
Subject of the Request
You can indicate your requested items by placing an “X” mark in the box under the Preference column in the table below for the items you wish to apply for.
Preference | Subject of Request |
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Is my personal data being processed in your clinic? | |
If my personal data is being processed in your clinic, I request information about the purpose of the processing activity and whether it is being processed in accordance with that purpose. | |
I request information about whether my personal data has been shared with third parties in Turkey or abroad and, if so, who it has been shared with. | |
I believe that the reasons for processing my personal data have ceased to exist, and I request the destruction of these data using an appropriate method (Deletion, Destruction, Anonymization). If requested, explanatory information/document regarding why you believe the reasons for processing your personal data do not exist should be provided to us. | |
I believe that my personal data in your clinic has been processed incompletely or incorrectly and request its correction. For this request, the information/document you believe to be incorrect and the information/document proving that your personal data is correct and complete should be submitted to us. | |
If my personal data in your clinic is incomplete or incorrect, I request that this situation be communicated to the third parties to whom my personal data has been transferred. If requested, the following information and documents should be provided to us: a) The content of your personal data that you believe is incomplete or incorrect, b) Documents showing the correct and complete information of your personal data. | |
If the reasons for processing my personal data have ceased to exist, I request that this situation be communicated to the third parties to whom my data has been transferred. If requested, explanatory information/document regarding why you believe the reasons for processing your personal data do not exist should be provided to us. | |
I object to the result that has arisen against me as a result of my processed personal data being exclusively analyzed through automated systems. If requested, information/document explaining the result against you should be provided to us. | |
I request compensation for damages incurred due to unlawful processing of my personal data. If requested, information/document showing the damages you have suffered should be provided to us. |
1-Identity and Contact Information of the Applicant
Please fill in the fields below so that we can contact you and verify your identity.
Information | |
---|---|
Name – Surname | |
T.C. Identification Number | (Passport number for citizens of other countries) |
Notification Address | |
Phone Number | |
Mobile Phone Number | |
Fax Number | |
Email Address | |
Your Relation to Our Clinic | Patient, Employee, Relative of a Patient, Other Business Partner |
In accordance with the requests I have stated above, I kindly request that my application be evaluated and that I be informed in accordance with Article 13 of Law No. 6698.
I declare and undertake that the information and documents I have provided in this application are correct and up to date.
Applicant Information (Data Owner)
- Name – Surname:
- Date:
- Signature: