GENERAL EXPLANATIONS:
It is regulated that the personal data owners (“Data Owner”) defined as the data subject in the Law on the Protection of Personal Data No. 6698 (“Law”) can use the rights granted with regard to their personal data in Article 11 of the Law and that they must apply to the Data Controller in order to exercise these rights. .
Pursuant to paragraph 1 of Article 13 of the Law; In the capacity of data controller, Assoc. Dr. Çiğdem YAYLA ABIDE (“Data Controller” or “Organization”), applications to be made regarding these rights must be submitted to us in writing or by other methods determined by the Personal Data Protection Board (“Board”).
APPLICATION PATH:
In this context, the applications to be made to our institution in “written”;
- By personally presenting a signed copy of this Application Form, which is filled out in full together with a document that will provide identification, to the address "Barbaros Mahallesi Akzambak Sokak Uphill Towers B Blok No:3-A Door No:100 Ataşehir - ISTANBUL",
- By sending a signed copy of this Application Form, which is fully filled together with a document that will provide identification, to the address "Barbaros Mahallesi Akzambak Sokak Uphill Towers B Blok No:3-A Door No:100 Ataşehir - ISTANBUL" through a notary public,
- By signing this Application Form with the "secure electronic signature" defined in the Electronic Signature Law No. 5070 and sending it to "info@drcigdemabide.com" via Registered Electronic Mail (KEP),
must be forwarded to us.
The channels mentioned above are “written” application channels in accordance with paragraph 1 of Article 13 of the Law. After the other methods to be determined by the Board are announced, our institution will announce how the 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 of receipt of your request, depending on the nature of the request, in accordance with paragraph 2 of Article 13 of the Law. However, if the transaction requires an additional cost, the fee in the tariff determined by the Personal Data Protection Board will be charged by our organization. Our answers will be delivered to you in writing or electronically in accordance with the provisions of Article 13 of the relevant Law.
According to this form and the nature of 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 properly, there may be problems in the full and qualified conduct of the researches 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 in a complete manner, including the requested information and documents, depending on the nature of your request.
KNOWING THE APPLICANT AND CONTACT INFORMATION ABOUT THE APPLICATION
The following information must be provided so that we can identify the “applicant” regarding your application and carry out the necessary research within our organization according to the nature of your request.
In addition, your contact information stated below is requested from you in order to get 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 :
ID or Passport Number :
Date of Birth :
E-mail :
Address :
Mobile No:
In order to ensure the security of your personal data, our Organization may contact you within seven (7) days from the date of receipt of your application for information, in order to confirm that you are the data owner, and may request some information and documents from you in this regard.
In case the requested information and documents are missing, the information and documents will have to be completed and forwarded to us upon our request. Until the information and documents are fully transmitted to us, the thirty (30) day period specified in article 13/2 of the Law regarding the conclusion of the request will be suspended.
Please indicate your relationship with our Institution. (such as patient, business partner, employee candidate, ex-employee, third-party company employee, shareholder)
☐ Patient ☐ Visitor ☐ Partner ☐ Other: …………………..
Unit/Person you contacted in our institution::………………….…………………………….
Subject: ……………………………………..…………………………………….……………...……………………
☐ Ex Employee Years Worked : ……………… ☐ Diğer: ……………………………………………… ☐ Shared a Job Application / Curriculum Vitae. Date : ……….. ☐ Üçüncü Kişi Firma Çalışanıyım Lütfen çalıştığınız firma ve pozisyon bilgisini belirtiniz ………………………………………………………
Please explain your request under the Law in detail:
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Please choose the method of notifying you of our response to your application:
- I want it to be sent to my address.
- I want it to be sent to my e-mail or KEP address.
- I want to pick it up personally.
(In case of receipt by proxy, a notarized power of attorney or authorization document is required.)
Request No Subject of the request Your choice
1 I want to find out if your organization processes personal data about me.
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 they are 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 think that my personal data is incomplete or incorrectly processed and I want them corrected. Write your personal data that you want to be corrected in the "Your Choice" field and send the documents showing the correct and complementary information as an attachment. (Copy of identity card, residence, etc.) Law on Protection of Personal Data Art. 11/1 (d) 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 think that the reasons for processing have disappeared and in this context, my personal data; a) I request it to be deleted. b) I request that it be made anonymous. Law on the Protection of Personal Data Art. 11/1 (e ) Only one box can be ticked. a) b)
7 I want my personal data (Request No 5), which I believe to be incomplete and incorrectly processed, to be corrected by the third parties to which it was transferred. Write your personal data that you want to be corrected in the "Your Choice" field and send the documents showing the correct and complementary information as an attachment. (Copy of identity card, residence, etc.) Law on the Protection of Personal Data Art. 11/1 (f) 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 think that the reasons requiring its processing have disappeared (Request No. 6) and within this framework, also before the third parties to whom my personal data is transferred; a) I request it to be deleted. b) I request that it be made anonymous. Law on the Protection of Personal Data Art. 11/1 (f) Only one box can be ticked. a) b)
9 I believe that my personal data processed by your organization is analyzed exclusively through automated systems, and as a result of this analysis, there is a result against me. I object to this conclusion. Write the analysis result that you think is against you in the "Your Choice" field and send the documents supporting your objection as attachments. Data Resulting from Analysis;
Law on the Protection of Personal Data, Article 11/1 (g)
10 I suffered damage due to the illegal processing of my personal data. I demand compensation for this damage. Write the matter that is the subject of illegality in the "Your Choice" field and attach the supporting documents. send as (Court decision, Board decision, documents showing the amount of material damage, etc.) Law on the Protection of Personal Data Art. 11/1 (h) Matter Subject to Unlawfulness;
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 informed.
Name Surname. :
Application Date :
Siganture :
