IN ACCORDANCE WITH THE PERSONAL DATA PROTECTION LAW
DATA OWNER APPLICATION FORM
Personal data owners (hereinafter referred to as “Data Owner”), who are defined as the relevant person in the Personal Data Protection Law No. 6698 (“Law”), are granted certain rights regarding the processing of their personal data in Article 11 of the Law.
According to Article 13, paragraph 1 of the Law; applications to be made to Dr. Melis Esin Ülger (our clinic), who is the data controller, regarding these rights must be submitted to us in writing or by other methods determined by the Personal Data Protection Board (“Board”).
This form has been prepared to facilitate your right to information by applying in accordance with Article 11 of the Personal Data Protection Law.
In order for your request to be fulfilled within the scope of the Personal Data Protection Law (“KVKK”), you must fill out the application form below clearly and completely and send it to us in writing.
In this context, applications to be made to Dr. Melis Esin Ülger in “written” form must be sent to us by filling out this form;
In person or through the application of the Applicant’s representative,
Through a notary,
If your e-mail address is registered in our office and/or if it can be confirmed that the sending e-mail address belongs to you, by sending it to the e-mail address “melis-ulger@hotmail.com”. Applications to be made by regular mail (PTT) or courier/cargo companies will be processed if they are received. However, it is recommended not to apply with such methods that cannot be detected or proven.
Information is provided below regarding the written application channels regarding how written applications will be delivered to us.
Application Method
Address to be Submitted
Information to be Specified in the Application Submission
Personal Application (Applicant/attorney coming in person and applying with a document proving their identity)
Dr. Melis Esin ÜLGER
Caddebostan Neighborhood Operator Cemil Topuzlu Street No:78 Floor:1 Flat:10 Caddebostan/Istanbul
“Request for Information within the Scope of the Personal Data Protection Law” must be written on the envelope.
Notification via notary
Dr. Melis Esin ÜLGER
Caddebostan Neighborhood Operator Cemil Topuzlu Street No:78 Floor:1 Flat:10 Caddebostan/Istanbul
“Request for Information within the Scope of the Personal Data Protection Law” must be written on the notification envelope.
E-mail with a verifiable sender
The subject of the e-mail should be “Personal Data Protection Law Information Request”.
Applications sent to us will be responded to free of charge within thirty (30) days from the date the request reaches us by one of the methods specified above (in applications made by regular e-mail, the identity of the sender is confirmed) in accordance with Article 13, paragraph 2 of the Personal Data Protection Law. However, in the event of an additional cost, Dr. Melis Esin Ülger reserves the right to charge you a fee according to the tariff to be determined by the Personal Data Protection Board. If the information and documents you provide to us are incomplete or incomprehensible, you may be contacted to clarify your application. Our responses will be delivered to the applicant in writing or electronically in accordance with Article 13 of the Personal Data Protection Law.
A. APPLICANT IDENTITY AND CONTACT INFORMATION
Name:
Surname:
TR ID Number:
Date of Birth:
Phone Number:
Address
E-mail Address:
The information requested with this form is necessary for the correct identification of your identity, detailed research regarding your request and to communicate the result of your application to you (“Purpose”) and may be processed for this Purpose. Therefore, please provide your information accurately and completely. Your requested personal data will not be used in any way other than to fulfill the Purpose.
B. YOUR RELATIONSHIP WITH US
Patient
Staff
Supplier
Other (please specify):
The unit/person you are in contact with within our institution:
Subject:
C. INFORMATION REGARDING THE SELECTION OF THE RIGHT TO BE EXERCISED BY THE APPLICANT
(Please check the box/boxes next to the statement appropriate to your request)
I would like to know whether your party processes personal data about me.
If your party processes personal data about me, I request information about these data processing activities.
If your party processes personal data about me, I would like to know the purpose of processing and whether they are used in accordance with the purpose of processing.
If my personal data is transferred to third parties at home or abroad, I would like to know these third parties.
I believe that my personal data is processed incompletely or incorrectly and I would like them to be corrected.
Although my personal data has been processed in accordance with the law and other relevant legal provisions, I want my personal data to be deleted.
Incomplete and incorrect