SPECIALIST DOCTOR TUBA CELEBI KAYHAN APPLICATION FORM ACCORDING TO THE PERSONAL DATA PROTECTION LAW
- GENERAL EXPLANATIONS
Personal data owners defined as the relevant person in the Law No. 6698 on the Protection of Personal Data (“Law”) (“Data Owner”) are granted certain rights regarding the processing of their personal data in Article 11 of the Law. In accordance with the first paragraph of Article 13 of the Law; Applications to be made regarding these rights to Spec. Dr. Tuba Çelebi Kayhan, who is the data controller on behalf of Spec. Dr. Tuba Çelebi Kayhan Dermatology Clinic, must be submitted to us in writing or through other methods determined by the Personal Data Protection Board (“Board”). Within this framework, applications to be made “in writing” to Spec. Dr. Tuba Çelebi Kayhan, who is the data controller on behalf of Spec. Dr. Tuba Çelebi Kayhan Dermatology Clinic, must be submitted in accordance with the procedures using this form.
| Application Procedure* | Address to Apply | Information to be Specified in Application Submission | Başvuruya Eklenecek Diğer Bilgiler |
| Application in Person (Personal Data Owner must apply in person with a document proving his/her identity) | Kınıklı Mah. 6019 Sok. No:16 İç Kapı No:3 Pamukkale/Denizli | Identification (passport, driver's license, etc.) | |
| Return Registered Notification via letter or notary | Kınıklı Mah. 6019 Sok. No:16 İç Kapı No:3 Pamukkale/Denizli | On the envelope "Personal Data Protection Law Information Request” will be written. | Photocopy of ID (passport, driver's license, etc.) |
| By signing with Secure Electronic Signature Application via Electronic Mail (KEP) | drtubacelebikayhan@gmail.com | In the subject line of the email “Personal Data Protection Law Information Request” will be written. |
* The application method has been determined as the “written” application channel in accordance with the first paragraph of Article 13 of the Law. If the Board determines other methods, it will be announced to you by the data controller on behalf of Spec. Dr. Tuba Çelebi Kayhan Dermatology Clinic. Your applications sent to us will be answered “as soon as possible and within thirty days at the latest” from the date your request reaches us, according to the nature of the request, in accordance with the second paragraph of Article 13 of the Law. The answers will be sent to you in accordance with the method determined by the Board. In order for your request to be met completely, the information and documents requested in the form must be provided to us completely and accurately.
- NECESSARY INFORMATION AND DOCUMENTS
Please fill out the following information completely:
Name Surname:
TR ID Number:
Your Relationship with Specialist Dr. Tuba Çelebi Kayhan Dermatology Clinic:
☐ Patient
☐ Patient relative
☐ Employee
☐ Business partner
☐ Former Employee
☐ Other:
Address:
Phone:
Email Address:
Has Your Relationship with Specialist Dr. Tuba Çelebi Kayhan Dermatology Clinic Ended?
III. APPLICANT'S REQUESTS
According to Article 11 of the Personal Data Protection Law, the rights you can request from Specialist Dr. Tuba Çelebi Kayhan, who is the data controller on behalf of Specialist Dr. Tuba Çelebi Kayhan Dermatology Clinic, are specified. The necessary evaluation will be made according to the rights you request and the answers will be sent to you in accordance with the 3rd paragraph of Article 13 of the Law.
| Subject of Request | Legal basis | Your request | |
|
| I would like to learn whether “Specialist Dr. Tuba Çelebi Kayhan Dermatology Clinic” processes personal data about me. | Personal Data's Protection Law Art. 11/1 (a) |
|
| If Spec. Dr. Tuba Çelebi Kayhan Dermatology Clinic processes my personal data, I request information about these data processing activities. | Personal Data's Protection Law Mad 11/1 (b) | ||
| Kişisel verilerim işlenmişse bunların işlenme amacını ve işlenme amacına uygun kullanılıp kullanmadığını öğrenmek istiyorum. | Personal Data's Protection Law Art. 11/1 (c) | ||
| If my personal data is transferred to third parties at home or abroad, I would like to know about these third parties. | KVK.m. 11/1 (ç) | ||
| I think that my personal data has been processed incompletely or incorrectly and I want it to be corrected. | Personal Data's Protection Law Mad 11/1 (d) | ||
| Although my personal data has been processed in accordance with the law and other relevant legal provisions, I think that the reasons requiring processing have disappeared and within this framework, I request ( )* regarding my personal data. | Personal Data's Protection Law Art. 11/1 (e) | *
| |
| My personal data that I think has been processed incompletely or incorrectly Demand No 5 I also want it to be corrected in the eyes of the third parties to whom it was transferred. | Personal Data's Protection Law Art. 11/1 (f) | ||
| Although my personal data has been processed in accordance with the law and other relevant legal provisions, the reasons requiring processing have disappeared. I think so (Request No. 6) and in this context, I also request ( ) * from the third parties to whom my personal data has been transferred. | Personal Data's Protection Law Art. 11/1 (f) | *
| |
| I believe that my personal data processed by Specialist Dr. Tuba Çelebi Kayhan Dermatology Clinic has been analyzed exclusively through automatic systems and that a result of this analysis has been obtained against me. I object to this result. | Personal Data's Protection Law Art. 11/1 (g) | ||
| I have suffered damages due to the unlawful processing of my personal data. I request compensation for this damage.*** | Personal Data's Protection Law Art. 11/1 (h) |
Make your additional explanations:
………………………………………………………………………………………………………………………………………………………………………………………………………………….……..
………………………………………………………………………………………………………………………………………………………………………………………………….……………………..
***Please provide information, documents and evidence that demonstrate your damages.
- APPLICANT'S DECLARATION
In line with the requests I have stated above, I kindly request that my application to Specialist Dr. Tuba Çelebi Kayhan Dermatology Clinic be evaluated and informed.
I declare and undertake that the documents and information I have provided to you in this application are accurate and up-to-date and belong to me. I allow the information and documents I have provided in the application form to be processed by Spec. Dr. Tuba Çelebi Kayhan, acting as the data controller on behalf of Spec. Dr. Tuba Çelebi Kayhan Dermatology Clinic, for the limited purposes of evaluating and responding to my application, delivering my application to me, and determining my identity and address.
| I request that the answer be sent to the address I have stated in the Application Form. | |
| I request that the answer be sent to the e-mail address I have specified in the Application Form. |
Applicant Relevant Person (Personal Data Owner)
Application Date: ……../……./……..
Name Surname:
Signature:
IMPORTANT NOTE: Applications must be made personally by the person. Applications cannot be made on behalf of a spouse, relative, child, etc. If Specialist Dr. Tuba Çelebi Kayhan, who is the data controller on behalf of Specialist Dr. Tuba Çelebi Kayhan Dermatology Clinic, suspects the identity of the applicant, she may request verification information regarding this from the person.
English 
Turkish 