Application Form

REGARDING THE APPLICATIONS TO BE MADE BY THE PERSONAL DATA OWNER TO THE DATA CONTROLLER

DATA SUBJECT APPLICATION FORM

GENERAL EXPLANATIONS:

In the Law No. 6698 on the Protection of Personal Data (‘Law’), it is regulated that personal data owners (‘Data Owner’), who are defined as the relevant person in the Law No. 6698 on the Protection of Personal Data (‘Law’), can use the rights granted in Article 11 of the Law regarding their personal data and should apply to the Data Controller to exercise these rights.

Pursuant to paragraph 1 of Article 13 of the Law; applications to be made to DENTIST ÖZGE ASMACIK YAĞCI (‘Data Controller’ or ‘Organisation’) in the capacity of data controller regarding these rights must be submitted to us in writing or by other methods determined by the Personal Data Protection Board (‘Board’).

APPLICATION PROCEDURE:

In this context, applications to be made to our organisation in ‘written’ form;

1. By submitting a wet signed copy of this fully completed Application Form together with a document that will ensure identification to the address "Sümer 2 Sokak No:36/18 Kat:5 Kızılay - Çankaya / Ankara ’ in person,
2. By sending a wet signed copy of this fully completed Application Form together with a document to ensure identification to the address ‘Sümer 2 Sokak No:36/18 Kat:5 Kızılay - Çankaya / Ankara’ via notary public,
3. By signing this Application Form with the ‘secure electronic signature’ defined in the Electronic Signature Law No. 5070 and sending it to the address ‘info@ozgeyagci.com’ via Registered Electronic Mail (KEP),

must be forwarded to us.

The above-mentioned channels are ‘written’ application channels pursuant to paragraph 1 of Article 13 of the Law. After the announcement of other methods to be determined by the Board, our organisation will announce how the applications will be received through these methods.
Pursuant to paragraph 2 of Article 13 of the Law, 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. However, if the transaction requires an additional cost, our organisation will charge the fee in the tariff determined by the Personal Data Protection Board. Our responses will be delivered to you in writing or electronically in accordance with Article 13 of the relevant Law.
The information and documents requested from you according to the nature of this form and your request must be provided to us completely and accurately. If the requested information and documents are not provided as required, there may be problems in the full and qualified execution of the researches to be carried out by our organisation based on your request. In this case, our organisation declares that it reserves its legal rights. For this reason, the relevant form must be sent completely and in a way to include the requested information and documents according to the nature of your request.

IDENTIFICATION OF THE APPLICANT AND CONTACT INFORMATION RELATED TO HIS/HER APPLICATION

In order for us to identify the ‘applicant’ regarding your application and to make the necessary investigations within our organisation according to the nature of your request, the following information must be provided.

In addition, your contact information specified below is requested in order to obtain more detailed information about your application, to inform you about our examination processes and to inform you about the results of your application.

Name Surname :

TR Identity Number :

Date of Birth :

Email :

(if you specify, we will be able to respond to you faster)

Address :

Mobile Phone :

In order to ensure the security of your personal data, within seven (7) days from the date of receipt of your application for obtaining information, our Organisation may contact you to confirm that you are the data subject and may request some information and documents from you in this regard.

In case the requested information and documents are incomplete, the information and documents will need to be completed and submitted to us upon our request. The thirty (30) day period specified in Article 13/2 of the Law regarding the finalisation of the request will be suspended until the information and documents are fully submitted to us.

Please indicate your relationship with our Organisation (such as patient, business partner, employee candidate, former employee, third party company employee, shareholder)

Please explain your request under the Law in detail:

………………………………………………………………………………………………………………………......................................................

………………………………………………………………………………………………………………………......................................................

………………………………………………………………………………………………………………………......................................................

………………………………………………………………………………………………………………………......................................................

………………………………………………………………………………………………………………………......................................................

Please select the method by which you will be notified of our response to your application:

• I want it sent to my address.
• I want it sent to my e-mail or KEP address.

(If you choose the e-mail method, we will be able to respond to you faster).

• I want to receive it by hand.

(In case of delivery by proxy, a notarised power of attorney or authorisation document is required).