ASV PRIVATE HEALTH, PRIVATE EDUCATION SERVICES, TOURISM AND MEDICAL TRADE LTD. CO.
(Private Markasya Oral and Dental Health Clinic)
DATA SUBJECT APPLICATION FORM

Within the scope of the Law on the Protection of Personal Data No. 6698 (“PDPL” or “the Law”), individuals defined as data subjects or their legal representatives (“Applicant” or “Data Subject”) are granted the right to make requests regarding the processing of their personal data, as regulated in Article 11 of the PDPL.

According to Article 13, paragraph one of the PDPL, applications to be made to the data controller, ASV Private Health, Private Education Services, Tourism and Medical Trade Ltd. Co., regarding these rights must be submitted in writing or by other methods determined by the Personal Data Protection Board (“the Board”). Depending on the nature of your request, it will be answered as soon as possible and at the latest within thirty days from the date it reaches the Data Controller. However, if the process requires an additional cost, a fee may be charged in accordance with Article 7 of the Communiqué.


APPLICATION METHODS

By Mail or In-Person Application:
The Applicant may apply in person or by mail to the address “Toros Mah. 805 Sk. Kurgu 1 Plaza No:14/1 Konyaaltı/Antalya” with a completed and signed application form and documents verifying their identity.

By Registered Electronic Mail (KEP):
The Applicant may apply by sending the application, signed with a “secure electronic signature” as defined in the Electronic Signature Law No. 5070, to asvsaglik@hs01.kep.tr.

By Mobile Signature or Secure Electronic Signature via Email:
The Applicant may apply by sending a petition signed with a mobile signature or secure electronic signature, or by filling out the “Application Form” and sending it to info@markasyadis.com.

Applications can also be made via notary or by other legally valid methods that allow identity verification.


APPLICATION FORM

Name/Surname:
Turkish ID Number:
Passport No/Foreign ID No:
Contact Number:
Email Address:
Fax:
KEP Address:
Postal Address:


YOUR RELATIONSHIP WITH OUR CLINIC

  • □ Supplier Employee
  • □ Business Partner
  • □ Other: ……………
  • □ Patient
  • □ Patient Relative
  • □ Patient Guardian/Representative
  • □ Employee
  • □ Supplier Representative

Department you are in contact with at our clinic: …………………………………
Subject: ……………
……………
……………


SUBJECT OF REQUEST TO BE SUBMITTED WITHIN THE SCOPE OF THE APPLICATION

☐ I want to know whether my personal data is being processed.
☐ If my personal data has been processed, I request information regarding this.
☐ I want to know the purpose of processing my personal data and whether they are used in accordance with their purpose.
☐ I want to know the third parties to whom my personal data is transferred domestically or abroad.
☐ I request the deletion, destruction, or anonymization of my personal data within the framework of the conditions stipulated by law.
☐ I request the correction of my personal data if it has been processed incompletely or incorrectly. (Please provide detailed information about the personal data you want corrected in the explanation section.)
☐ If changes are made to my personal data upon my request, I want this to be notified to third parties to whom my personal data has been transferred.
☐ I request compensation for damages I have suffered due to the unlawful processing of my personal data. (Please provide detailed information in the explanation section about which data processing activity caused the damage, when, and how.)


YOUR REQUEST
Please specify your request in detail within the scope of the Law on the Protection of Personal Data No. 6698 in the area to the right.


PLEASE SELECT THE METHOD BY WHICH YOU WOULD LIKE TO RECEIVE OUR RESPONSE TO YOUR APPLICATION

  • I want it to be sent to my address. (It will be sent to the address specified in the application.)
  • I want it to be sent to my email address.
  • I want to receive it in person. (If received by proxy, a notarized power of attorney or authorization document is required.)

(If no response method is selected, the application will be answered by the method it was submitted.)
(If you choose the email method, we will be able to respond to you more quickly.)


This application form has been prepared to ensure that your requests are answered accurately, completely, and within the period specified by law. As the data controller, we reserve the right to request additional documents and information (such as a copy of your ID card or driver’s license) for identity and authority verification, to prevent unauthorized persons from applying and accessing personal data, and to ensure the security of your personal data. If the information you provide regarding your requests is not accurate and up-to-date, or if the application is made with incorrect/misleading information or by unauthorized persons, your application will be rejected and legal action will be taken against the person who performed the improper transaction.

Our company reserves the right to request additional information and requests for the evaluation of the Personal Data Subject Application Form.

Even if data deletion requests are fulfilled, we would like to inform you that we are obliged to share the data with official authorities if requested by official authorities.

I declare and undertake that the information contained in this Personal Data Subject Application Form is accurate and up-to-date:

Name/Surname:
Date:
Signature:

Please attach and send documents showing your relationship with the applicant and/or your authority, such as a power of attorney, population registration sample, or relevant document, with your application.