GENERAL INFORMATION:

This clarification text herein is based on the Law No. 6698 on the Protection of Personal Data in the Turkish Legal Legislation (“KVKK”), European Union General Data Protection Regulation (“GDPR”), by the Communiqué on the Regulation on Personal Health Data and the Procedures and Principles to be Followed in Fulfilling the Obligation to Clarify. It has been prepared for the purpose of enlightening the data owners about the procedures and principles regarding the processing of the Personal Data of the patients applying to Aesthetic, Plastic and Reconstructive Surgery Specialist Dr. Burak Ersen (“Dr. Burak Ersen Clinic”) or (“Dr. Burak Ersen”).

KVKK regulates that individuals defined as data owners (“Related Person“) in the Law can exercise the rights granted regarding their personal data in Article 11 of the Law, and that the Related Person needs to apply to the Data Controller to exercise these rights.

In accordance with the first paragraph of Article 13 of the Law, as Data Supervisor Dr. Burak Ersen applications regarding these rights must be submitted to Dr. Burak Ersen Clinic in writing, through email via the internet, or through other methods determined by the Personal Data Protection Board (‘Board’).

APPLICATION METHOD:

You can proceed your request regarding your rights listed above by filling out the application form, which you can obtain from Dr. Burak Ersen Clinic. You can send it to Dr. Burak Ersen Clinic by the means set forth below.

In the application procedure, Dr. Burak Ersen carries out his transactions within the scope of the Communiqué on the Procedures and Principles of Application to the Data Controller. In this context, the application must be made in accordance with Article 5 of the aforementioned communiqué.

Provided that, the form is duly filled;

• A wet-signed copy of the Application Form, together with a document providing identification to be submitted personally to the address Atatürk Mah. Ertuğrul Gazi Sok. A Blok No:2E Daire:298 Ataşehir/İSTANBUL,
• A wet-signed copy of the Application Form, together with a document providing identification to be submitted the address Atatürk Mah. Ertuğrul Gazi Sok. A Blok No:2E Daire:298 Ataşehir/İSTANBUL via a notary public,
• By signing the Application Form with the “secure electronic signature” defined in the Electronic Signature Law No. 5070 to be signed and to be sent to e-mail address infodrburakersen@gmail.com,
• In addition, by filling out and signing this application form, scanning the wet-signed form and uploading it to the computer, by sending an e-mail to infodrburakersen@gmail.com (if this method is preferred, a document that will provide identification should be attached to the e-mail),
• Or it should be communicated to us using other methods to be determined by the Board.

In the application herein;

• It is obligatory to have name, surname and signature, T.R. for citizens of the Republic of Turkey. identification number, nationality for foreigners, passport number or identification number, if any, place of residence or workplace address for notification, e-mail address for notification, telephone and fax number, if any, and the subject of the request.

Information and documents related to the subject are attached to the application.

In written applications, the date on which the document is notified to the data controller or its representative is the application date.

In applications made by other methods; the date on which the application reaches the data controller is the application date.

Dr. Burak Ersen Clinic will finalize your requests regarding the rights listed above in writing or by other methods to be determined by the Board, as soon as possible and within thirty days at the latest after the date of submission. Applications of data owners may be charged within the framework of the tariffs published by the Board. In accordance with Article 7 of the relevant Communiqué, if your application is to be answered in writing, up to ten pages will not be charged. A transaction fee of 1 Turkish Lira may be charged for each page over ten pages. If the response to the application is given in a recording medium such as a CD or flash memory, the fee that may be requested by the data controller cannot exceed the cost of the recording medium.

             In order to respond to your applications made as data owners, Dr. Burak Ersen Clinic may request additional information and documents in order to verify the identity of the applicant, to prevent unlawful transmission of another person’s personal data to unrelated persons and to clarify the applicant’s request. If the said information and documents are not shared, the application of the data owner may not be answered.

             Confirmation that the application has been made by the “identity holder” and/or the authorized person is of serious importance. Likewise, while the purpose is to protect personal data, giving personal data to third parties due to the inability to verify identity and taking action within the rights set forth in Article 11 of the KVKK will harm the interests of the person concerned. For this reason, you will understand our sensitivity in terms of identity verification processes and we hope that you will help Dr. Burak Ersen Clinic.

             Dr. Burak Ersen Clinic will finalize the requests as soon as possible and within 30 days at the latest. The result of the evaluation is notified to the person concerned in writing or electronically, and if the request is accepted, necessary action is taken in accordance with the KVKK.

             In cases where the applications of the persons concerned are rejected, the response is found insufficient or the application is not answered in due time, the person concerned may file a complaint with the Personal Data Protection Board in accordance with Article 14 of the KVKK within 30 days from the date of learning the answer.

             Depending on the nature of your request and your application method, Dr. Burak Ersen Clinic may request additional verifications (such as sending a message to your registered phone, calling) in order to determine whether the application belongs to you or not, and thus to protect your rights. For example, if you apply via your e-mail address registered in Dr. Burak Ersen Clinic, we can reach you using another communication method registered with Dr. Burak Ersen Clinic and request confirmation of whether the application belongs to you.

IDENTIFICATION OF THE APPLICANT AND CONTACT INFORMATION REGARDING THEİR APPLICATİON

In order for us to identify the ‘applicant’ related to your submitted application and to conduct necessary investigations within Dr. Burak Ersen Clinic based on the nature of your request, the following information needs to be provided.

In order for us to identify the ‘applicant’ related to your submitted application and to conduct necessary investigations within Dr. Burak Ersen Clinic based on the nature of your request, the following information needs to be provided.

Furthermore, the contact information provided below is required for the purpose of obtaining more detailed information regarding your application, informing you about our reviewing process, communicating the outcomes of your application, preventing third-party applications that might mislead us by using your name, distinguishing applications from individuals with the same name, and avoiding confusion in the data.

Name and Surname                           :

Turkish ID No/ Nationality, Passport Number or ID Number (if any) for Foreigners     :

E-mail Address                                  :

(If you request the response via email, please fill out)      

Address                                              :

(If you are requesting the response to be sent to your address, please fill out)    

Mobile Phone                        :

In order to ensure the security of your personal data, from the date your information request reaches Dr. Burak Ersen Clinic and during the application period, Dr. Burak Ersen Clinic may contact you to verify your identity.

If the requested information and documents are incomplete, it will be necessary to complete and provide them to us upon our request. If the information and documents are not fully provided to us, and as a result, processing of the application cannot be carried out, a response explaining this situation will be provided within the specified thirty (30) days.

Please specify your relationship with Dr. Burak Ersen Clinic. (Patient, employee, job applicant, former employee, employee of a third-party company, etc.)

Please choose the method of communication for informing you about the response to your application

• I want it to be sent to my address
• I want it to be sent to my email
• I want to receive it in person.

(If it is to be collected by proxy, a notarized power of attorney or authorization document is required.)

Please provide a detailed explanation of your request within the scope of the Law: (If the table above is insufficient to explain your request, please fill out this section as well)

…………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………

I request that my application be evaluated considering the information and requests I have provided above, and a response be provided to me in the manner I have chosen.

Date               :

Signature       :