INFORMATION AND CONSENT FORM REGARDING THE PROCESSING AND PROTECTION OF PERSONAL DATA

(Law No. 6698 on the Protection of Personal Data, dated 24.03.2016)

As Dr. Utkan Kızıltaç We take utmost care to comply with the Constitution and the Law No. 6698 on the Protection of Personal Data in the processing and storage of your personal data, and we take the highest level of security measures to ensure the security of your personal data. As the Data Controller under the Law No. 6698 on the Protection of Personal Data and related legislation, Dr. Utkan Kızıltaç processes your personal data in accordance with the Regulation on the Processing of Personal Health Data and Ensuring Privacy, as explained below., In accordance with the regulations of the Ministry of Health and other legislation, your personal data will be recorded, archived, shared with third parties/institutions (as listed below) when necessary, and processed in the ways stipulated in the Law on the Protection of Personal Data. Therefore, we inform you about our mutual rights and obligations below and request your explicit consent.

A-INFORMATION :

Processing of Your Personal Data and Data Controller

In accordance with the law, your personal data is recorded and stored by us as the Data Controller and Data Processor to establish the service relationship, ensure the continuity of services, perform our services, and fulfill our responsibilities arising from other laws as a medical/examination center.

Within the framework of Article 3/I(d) of the Personal Data Protection Law, "personal data" refers to any information relating to an identified or identifiable natural person. In this context, personal data refers to any information relating to an identified or identifiable natural person.

Within the framework of Article 3/I(e) of the Personal Data Protection Law, the processing of personal data refers to any operation performed on data, such as obtaining, recording, storing, preserving, modifying, reorganizing, disclosing, transferring, acquiring, making available, classifying, or preventing the use of personal data, whether wholly or partly automated or non-automated, provided that it is part of any data recording system.

2. Identity of the Data Controller

According to the Personal Data Protection Law (KVK Law), "Data Controller" refers to the natural or legal person who determines the purposes and means of processing personal data and is responsible for the establishment and management of the data recording system; therefore, the addressee under the KVK Law is the "Data Controller".

Dr. Utkan Kızıltaç's corporate identity information is as follows:

Head Office Address: Caddebostan Mh. Bağdat Cad. Erenköy Palas Apt. No 322, Floor 5, Apartment 12.

Phone: +90 532 689 2416

Website: [email protected]

Email Address: [email protected]

3. Personal Data Processed

Your personal and sensitive personal data included in the registration form, primarily your health data:

Your personal information (Name, Surname, Turkish Republic Identity Number and/or passport number and/or temporary Turkish Republic Identity Number, place and/or date of birth, marital status, gender, health insurance, occupation, insurance card number, workplace registration and/or patient identification number, and other identifying data that can identify you)
Your contact information (address, telephone number, email address and other contact details, as well as personal data obtained when you contact us via email, letter and/or other means);
Your financial data such as bank account number, IBAN number, credit card information, billing and invoice information;
For the purpose of financing and planning healthcare services, we collect your data regarding private health insurance and information on payer institutions such as the Social Security Institution;
Your data, including but not limited to patient medical reports, diagnostic data, biometric and genetic data, laboratory results, test results, examination data, doctor's analyses and comments, appointment information, and prescription information, as well as all other health information obtained during and/or as a result of medical diagnosis, treatment, and care services;
If you contacted the call center, you have a recording of your voice call.
If you used the parking and valet service, your vehicle license plate information.
Your feedback, such as surveys, thank you letters, complaint letters, and satisfaction results.
Your personal data, including your IP address, cookies and other personal data obtained during your use of our website and mobile applications, as well as your browsing data and medical data that you voluntarily provide through the mobile application, is included in this data.;

Your personal data is recorded in accordance with the Law No. 6698 on the Protection of Personal Data and the Regulation on the Processing of Personal Health Data and Ensuring Privacy, and this personal data may also be processed in our archives in a manner that is relevant and proportionate to the purposes stated in Article 4 and may be transferred to the individuals, institutions and organizations specified in Article 5.

4. Purposes of Personal Data Processing

Your personal data may be processed for the following purposes:

Identity verification and authentication are necessary to prevent your personal data from being accessed by others.,
The protection of public health, preventive medicine, medical diagnosis, treatment and care services, planning and management of health services and their financing,
Providing you with customized medication and/or medical supplies and/or devices,
If you schedule an appointment, we can inform you and provide information about your appointment.
and/or appointment reminder
In accordance with the legislation, sharing information with and responding to the Ministry of Health and other public institutions and organizations,
Sharing information and verifying identity requested by contracted institutions/organizations, primarily private insurance companies, within the scope of financing healthcare services. (if you have private health insurance AND IF YOU USE YOUR PRIVATE INSURANCE)

Issuing invoices for the services we provide,
We use your healthcare usage to analyze and store your health data in order to improve and enhance the healthcare services we provide, and to respond to your questions or complaints regarding our services.
Providing necessary information in accordance with requests and inspections from regulatory and supervisory bodies and official authorities.,
To maintain your health data that must be kept in accordance with relevant legislation.,
We will conduct promotional and informational activities tailored to your needs and ensure you benefit from them, and we will contact you to provide information regarding our services.
These include, but are not limited to, the implementation and development of medical diagnosis, treatment, and care services; the planning and management of healthcare services and their financing; increasing patient satisfaction; research; and related reasons.

Your personal data/personal information obtained and processed in accordance with the relevant legislation, To Dr. Utkan Kızıltaç The relevant physical archives and/or information systems can be used to transfer the data and/or keep it under safekeeping in both digital and physical formats.

5 – Transfer of Personal Data

By ensuring that all necessary technical and administrative measures are taken to provide an appropriate level of security in accordance with the KVKK (Personal Data Protection Law) and relevant health legislation, your personal data/personal information will be processed for the purposes stated in Section 4;

Individuals, institutions, and/or organizations permitted by the provisions of Law No. 3359 on Basic Health Services, Decree Law No. 663 on the Organization and Duties of the Ministry of Health and its Affiliated Institutions, Law No. 6698 on the Protection of Personal Data, the Regulation on the Processing of Personal Health Data and Ensuring Privacy, and other relevant legislation;
The Turkish Ministry of Health, Provincial Health Directorates, and other units affiliated with the Ministry of Health.
For patients covered by SGK (Social Security Institution), with the Social Security Institution, your private insurance if you use (If applicable) your insurance company, and if your billing will be to the institution you work for, your institution.
Our direct/indirect domestic/foreign shareholders, subsidiaries and/or affiliates; our group companies
With our partners

With the legal representatives we work with, including lawyers, consultants, and auditors, and with whom we have received advice and authorization.
We cooperate with and/or contract with domestic/foreign organizations and other third parties, as well as their legal representatives, to carry out our activities.

We collaborate with laboratories, ambulance services, medical equipment providers, and healthcare service providers both domestically and internationally for medical diagnosis and treatment.
This information may be shared with your legal representatives to whom you have given authorization.

6- Your Rights as a Data Subject as Listed in Article 11 of the Law

In accordance with Article 11 of the Personal Data Protection Law, you can apply to our Healthcare Institution to find out whether your personal data is being processed, request information regarding the processing of your personal data if it has been processed, and request further information about your personal data.of You can learn the purpose of processing and whether the data is being used in accordance with its purpose, whether personal data has been transferred, and if so, the third parties to whom it has been transferred, both domestically and internationally, and request the correction of personal data if it has been processed incompletely or incorrectly, as well as learn about the purpose, duration, and legitimacy of the data processing.

You may request the deletion or destruction of your personal data if the reasons requiring its processing, within the framework of established principles, cease to exist. You may also request that third parties to whom your personal data has been transferred be notified of any corrections, deletions, or destructions. If the processing of your personal data is carried out exclusively through automated systems and an unfavorable outcome arises, you may object to this outcome, and if your personal data is processed unlawfully and you suffer damages as a result, you may request compensation for those damages.

To exercise your rights mentioned above, please submit your request, including the necessary information to identify your identity and your explanations regarding the right you wish to exercise as specified in Article 11 of Law No. 6698 on the Protection of Personal Data, via a notary public, as indicated in the information text provided.

Caddebostan Mh. Bağdat Cad. Erenköy Palas Apt. No 322 Floor 5 Apartment 12.

You can send it to our address; or you can personally deliver it to our address with documents and information identifying your identity, or you can send it via email to [email protected] with a secure electronic signature.

7-Situations in Which Personal Data May Be Processed Without Explicit Consent According to the KVKK (Law on Protection of Personal Data):

In accordance with Article 5 of the KVKK (Law on Protection of Personal Data) and Article 7 of the Regulation, your personal data(s) listed below may be processed without your explicit consent in the following cases:

In cases explicitly provided for by law,
If you are unable to express your consent as a data subject due to factual impossibility, or if your consent is not legally valid, and the processing of your personal data is necessary for the protection of your or another person's life or physical integrity,
The processing of your personal data(s) belonging to the parties to a contract is necessary provided that it is directly related to the establishment or performance of the contract.,
It must be necessary for the fulfillment of a legal obligation.,
Your personal data/personal information has been made public by you,
Data processing must be necessary for the establishment, exercise, or protection of a right.,
Personal health data may be processed by persons or authorized institutions and organizations bound by an obligation of confidentiality, without seeking the explicit consent of the data subject, for the purposes of protecting public health, preventive medicine, medical diagnosis, treatment and care services, and planning and managing health services and their financing.

NAME AND SURNAME:

SIGNATURE:

B. EXPLICIT CONSENT (APPROVAL)

I consent to the processing, storage, and transfer of my personal data by the data controller, Dr. Utkan Kızıltaç, and the data processor (Dr. Utkan Kızıltaç's employees registered with the Social Security Institution) as explained above;

Moreover;

In order to obtain a second opinion regarding the diagnosis and treatment of my health condition, I consent to the transfer of my personal information, visual and health data to domestic or foreign healthcare institutions and organizations with which you collaborate that provide expert opinions;
I understand that the transfer of my medical data to my private insurance company, or an agency authorized by my private insurance company, is necessary for me to benefit from private health insurance and for my treatment costs to be paid, and that this transfer is essential for the provision and billing processes of the health services I receive from your clinic/practice. Therefore, I consent to the transfer of my personal health data by Dr. Utkan Kızıltaç and the data processor (Dr. Utkan Kızıltaç's employees registered with the Social Security Institution) to my private insurance company or an agency authorized by my private insurance company for these purposes.,
I consent to the processing of my medical photographs, including those taken by the physician during the procedure, and to the taking, recording, storage, and processing of photographs during the intervention/treatment I will undergo, along with the personal data shared above.
I request that I be informed about my appointment and campaign information via email, social media, or SMS to my phone, and that notification of the sharing of my financial information be sent to the email address ………………………………………………………….

With my explicit consent

HISTORY………./……../………

I agree……………………………….

I do not accept…………………………..

(Please indicate this in your own handwriting)

NAME AND SURNAME:

SIGNATURE:

As Dr. Utkan Kızıltaç;

your medical information only

You (the patient)
Your legal representative for certain health conditions
Institutions and organizations to which you have given your explicit consent
State institutions within the framework of our judicial and legal obligations.

The information listed below will be shared with the person(s) you authorize. Please specify the individuals with whom you authorize sharing your information and their relationship to you.

Information	Names and degree of kinship
My appointment details
General information about my health condition
My test results
My medical records

**Name and signature of the data subject, patient or legal representative:……………………………………

If the legal representative is a relative of the patient, the degree of relationship is:………………………………………………………

(This section must be filled out by hand, indicating the relationship to the legal representative.)

HISTORY:…………………………………………………………………………………………

****If an interpreter/witness is required

Translator's/Witness's Name and Surname:……………………………………………………………

Personal Data Protection Law (KVKK)