GENERAL INFORMATION
Pursuant to Article 20 of the Constitution of the Republic of Turkey, everyone has the right to request the protection of personal data concerning themselves. This right also includes the right to be informed about personal data relating to oneself, to access such data, to request its correction or deletion, and to learn whether it is being used for its intended purposes.
Law No. 6698 on the Protection of Personal Data (“PDPL”) grants data subjects (hereinafter referred to as “Applicants”), as defined as “data subjects” under the Law, the right to submit certain requests regarding the processing of personal data under Article 11 of the PDPL.
Özel Küçükçekmece International Plus Ağız ve Diş Sağlığı Polikliniği – License Holder Bfr Ağız Ve Diş Sağlığı Hizmetleri A.Ş. (hereinafter referred to as “International Plus” or the “Clinic”), in accordance with Article 13 of the PDPL, has prepared this Data Subject Request Form in its capacity as data controller for the purpose of evaluating the rights of data subjects and providing the necessary information to them.
- RIGHT TO APPLY
Subjects of Application
Pursuant to Article 11 of the PDPL, any person whose personal data is processed may apply to our Clinic and make requests regarding the following matters:
- Learning whether their personal data is being processed,
- Requesting information if their personal data has been processed,
- Learning the purpose of processing their personal data and whether it is being used in accordance with its purpose,
- Learning the third parties to whom their personal data has been transferred domestically or abroad,
- Requesting the correction of their personal data if it has been processed incompletely or inaccurately, and requesting that such correction be notified to the third parties to whom the personal data has been transferred,
- Requesting the deletion, destruction, or anonymization of their personal data if the reasons requiring its processing have ceased to exist, and requesting that such operation be notified to the third parties to whom the personal data has been transferred,
- Objecting to the occurrence of a result against the data subject by means of analysis of the processed data exclusively through automated systems,
- Requesting compensation for the damage suffered if their personal data is processed in violation of the law.
Cases Outside the Scope of the Right to Apply
Pursuant to Article 28 of the PDPL, data subjects shall not be able to assert their rights in the following cases:
- Processing of personal data by natural persons for purposes relating entirely to themselves or to family members residing in the same household, provided that the data is not disclosed to third parties and that data security obligations are complied with
- Processing of personal data for research, planning, and statistical purposes by making it anonymous through official statistics
- Processing of personal data for artistic, historical, literary, or scientific purposes, or within the scope of freedom of expression, provided that it does not violate national defense, national security, public security, public order, economic security, the right to privacy, or personal rights, or constitute a crime
- Processing of personal data by public institutions and organizations authorized by law with duties and powers for the purposes of carrying out preventive, protective, and intelligence activities for national defense, national security, public security, public order, or economic security
- Processing of personal data by judicial authorities or enforcement authorities in relation to investigation, prosecution, trial, or enforcement proceedings
Pursuant to Article 28, paragraph 2 of the PDPL, data subjects shall not be able to assert their rights, except for the right to request compensation for damages, in the following cases:
- Processing of personal data is necessary for the prevention or investigation of a crime
- Processing of personal data that has been made publicly available by the data subject themselves
- Processing of personal data is necessary for authorized and competent public institutions and organizations and professional bodies with public institution status to carry out supervisory or regulatory duties or disciplinary investigations or prosecutions based on the authority granted by the law
- Processing of personal data is necessary for the protection of the State’s economic and financial interests in relation to budgetary, tax, and financial matters
- METHODS OF APPLICATION
Requests by data subjects regarding their rights arising from the PDPL must be submitted to us in writing, in compliance with Article 13 of the PDPL, or through other methods to be determined by the Personal Data Protection Board (the “Board”).
In this context, for “written” applications to our Clinic, a printout of this form must be submitted:
- In person by the Applicant,
- In writing via cargo, mail, or notary,
- Using a “secure electronic signature” as defined in Law No. 5070 on Electronic Signatures, a mobile signature, or the e-mail address that you have previously provided to our Clinic and that is registered in our systems.
| Method of Application | Description | Application Address |
| Cargo / Mail / Notary | Completing the application form available at https://www.internationalplusclinic.com | Halkalı Merkez Mah. Basın Ekspres Cad. Capıtal Tower No: 9 Ic Kapı No: 5 Küçükçekmece İstanbul |
| Via secure electronic or mobile signature, or through your registered e-mail address | bfragizdis@hs01.kep.tr |
Applications must be submitted with the note “Information Request within the Scope of the Personal Data Protection Law.”
- CONTACT INFORMATION OF THE DATA SUBJECT
*Fields marked with an asterisk are mandatory.
Please fill in the fields below accurately and completely so that the necessary research and assessments can be conducted and solutions can be developed regarding your request.
| Full Name* | |
| Nationality* | |
| Turkish ID / Passport Number* | |
| Address* | |
| Phone Number* | |
| E-mail Address* | |
| Relationship with Our Institution | ☐ Patient ☐ Employee
☐ Visitor ☐ Job Applicant ☐ Subcontractor Employee ☐ Other (Please specify): _______________ |
| Current Status of Relationship | ☐ My relationship with Özel Küçükçekmece International Plus Ağız ve Diş Sağlığı Polikliniği is ongoing as of the date of this application.
☐ My relationship with Özel Küçükçekmece International Plus Ağız ve Diş Sağlığı Polikliniği ended as of (…./……../………). |
- REQUESTS THAT MAY BE SUBMITTED BY DATA SUBJECTS
As a data subject, please mark the relevant box/boxes in the list below for the situation(s) regarding which you wish to obtain information within the scope of Articles 11 and 13 of the PDPL.
| No. | Topics that May Be Requested and Legal Basis | Your Selection |
| 1 | I would like to learn whether my personal data is being processed within your institution. (PDPL Art. 11/1 (a)) | |
| 2 | If my personal data is being processed, I request information about this data processing activity. (PDPL Art. 11/1 (b)) | |
| 3 | If my personal data is being processed, I would like to learn the purpose of this processing and whether it is being used in accordance with its purpose. (PDPL Art. 11/1 (c)) | |
| 4 | I request information about whether my personal data has been transferred to third parties domestically and/or abroad, and if so, about those third parties. (PDPL Art. 11/1 (c)) | |
| 5 | I request the correction of my personal data that has been processed incompletely or inaccurately by your institution / the third parties to whom my personal data has been transferred. (If applicable, accurate and supplementary information/documents must be submitted.) (PDPL Art. 11/1 (d)) | |
| 6 | I believe that the reasons requiring the processing of my personal data have ceased to exist, and I request: ☐ Deletion ☐ Anonymization of my personal data (please indicate your selection with an x). (PDPL Art. 11/1 (e)) | |
| 7 | I also request that the personal data I believe to have been processed incompletely or inaccurately (Request No. 5) be corrected in the records of the third parties to whom it has been transferred. (PDPL Art. 11/1 (f))
I also request: ☐ Deletion ☐ Anonymization of the personal data I believe to have been processed incompletely or inaccurately (Request No. 5) in the records of the third parties to whom it has been transferred (please indicate your selection with an x). (PDPL Art. 11/1 (f)) |
|
| 8 | I object to the result that has arisen against me through analysis of my personal data exclusively by automated systems. (PDPL Art. 11/1 (g)) | |
| 9 | I request compensation for the damage I have suffered due to the processing of my personal data in violation of the law. (PDPL Art. 11/1 (h)) |
- OUR CLINIC’S PROCEDURE AND TIMELINE FOR RESPONDING TO APPLICATIONS
In accordance with Article 13 of the PDPL, our Clinic shall conclude the requests submitted by data subjects in the shortest time possible, and within thirty (30) days at the latest, free of charge, depending on the nature of the request. However, if the transaction requires an additional cost, the fee set by the Board’s tariff may be requested from the data subject.
For applications to be made by third parties on behalf of the data subject, a notarized power of attorney must be submitted together with this Application Form; for applications to be made on behalf of minors under guardianship or trusteeship, a copy of the documents supporting the guardianship/trusteeship relationship must be submitted together with this Application Form.
In order to ensure the security of your personal data, when your information request reaches our Clinic, our Clinic may request information and documents from the applicant for the purpose of verifying identity and authority. The information and documents provided to us in this context shall be immediately destroyed upon confirmation of your status as the data subject.
In the event that the requested information and documents are incomplete, such information and documents must be completed and submitted to us upon our request. The thirty (30)-day period specified in Article 13/2 of the PDPL for concluding the request shall be suspended until the information and documents are fully submitted to us.
The data subject’s application may be rejected in the following cases:
- Where it would hinder the rights and freedoms of others
- Where it would require disproportionate effort
- Where the information is publicly available
- Where it would jeopardize the privacy of others
- Where one of the cases excluded from the scope pursuant to the PDPL exists
- CONCLUSION OF THE DATA SUBJECT’S REQUEST
Depending on its nature, your request shall be answered in the shortest time possible, and within thirty (30) days at the latest, following the date it is received by us pursuant to the PDPL. Our responses and assessments shall be communicated to you in accordance with your selection specified in this Application Form, pursuant to Article 13 of the PDPL. Please indicate your preference for how our Clinic will notify you of the response to your application:
| 1 | I would like it to be sent to my address via mail. |
| 2 | I would like to receive it in person. (In case of receipt by proxy, a notarized power of attorney or authorization document must be presented.) |
| 3 | I would like it to be sent to my e-mail address. |
- RIGHT OF THE DATA SUBJECT TO FILE A COMPLAINT WITH THE BOARD
Pursuant to Article 14 of the PDPL, if the application is rejected, the response given is found to be insufficient, or a response is not provided within the stipulated period, the data subject may file a complaint with the Board within thirty (30) days from the date on which they learn of the Clinic’s response, and in any case within sixty (60) days from the date of application.
Pursuant to Article 14/2 of the PDPL, no complaint may be filed with the Board without first applying to our Clinic.
Data Subject (Applicant):
Full Name and Surname: __________________________________
Date of Application: __________________________________
Signature: __________________________________
