As Dr. Düzgün Ateş, we may need to learn your personal information and health data in order to carry out the services I will provide to you and to record and store them within the limits required by the service to be provided.

Your health data that we have to record in order to provide health services to you are accepted as special quality personal data by law. In this context, pursuant to the provision “It is forbidden to process special categories of personal data without the explicit consent of the person concerned” in paragraph 2 of Article 6 of the Personal Data Protection Law No. 6698, personal health data can only be recorded with the explicit written consent of the person, except for the special conditions specified in the law, and it has become obligatory to obtain this consent from you.

INFORMATION TEXT

This consent includes the personal data you provide to us verbally, in writing, visually or electronically during our examination, and the personal data you transmit to us via the internet and mobile applications or electronically or obtained in our practice (analysis results, prescription, camera recording, video, photo, etc.). It covers your personal data.

In this sense, your name, surname, TR ID number, (if you are not a Turkish citizen, your passport number or temporary TR ID number), your place and date of birth, marital status, gender, especially the personal health data required to carry out the services we will provide to you and obtained for this purpose. Your identity data such as your personal information and various identification documents, your contact data such as your address, telephone number, e-mail address, your financial data such as your bank account number, IBAN number, your medical history in your clinical file, information showing your disease history, your examination data, data regarding the procedures applied to you, Your health and sexual life data obtained during the execution of medical diagnosis, treatment and care services, such as your prescription information, photographs, all kinds of images, audio/camera recordings, laboratory and imaging results, test results, your data regarding private health insurance and your Social Security Institution data. etc. is considered personal data.

This personal data of yours will be recorded only to the extent required by the health service to be provided to you within the framework of the Personal Data Protection Law No. 6698 and the relevant legislation, and will be stored in our system/archive “…not to exceed the period necessary to achieve the purposes for which it is recorded.” In this context, your data processed will be protected as a professional secret, confidentiality will be ensured and will not be shared by third parties/institutions/organizations.

However, in cases where the confidentiality of personal medical records must be limited for the protection of public health, such as the obligation to notify the competent authorities of infectious diseases regulated in Article 58 of the General Hygiene Law No. 1593, or in cases of legal obligation such as the obligation to report a crime, it can only be used limited to the purpose and in moderation. We would like to remind you that it may be necessary to notify the competent authorities.

Requests from public institutions, judicial authorities and other official authorities to transmit your data to them, the purpose of the request, whether the requested data overlaps with the purpose to be achieved, whether it can be stated in concrete form, the necessity of transmitting your data without anonymization as the only way to achieve the stated purpose, the data It will be evaluated in terms of whether the transmission is necessary in a democratic society or not, and requests for data transmission that do not meet all of these elements will not be fulfilled.

Regarding your data recorded by us, in accordance with the Convention for the Protection of Individuals with Regard to Automatic Processing of Personal Data (Council of Europe Convention No. 108), Article 8 of the European Convention on Human Rights, Article 20 of the Constitution, Personal Data Protection Law No. 6698:

Learning whether your personal data is being processed and the scope of your processed data,

If your personal data has been processed, obtaining information about it, accessing this data and taking samples from it,

To learn the purpose of processing of your personal data and whether they are used for their intended purpose, whether they are transferred to a third person or institution at home or abroad, and to request that changes in your personal data be notified to the persons or institutions with whom the data is shared,

Requesting correction of your personal data in case it has been processed incompletely or incorrectly, (This right can be exercised by applying in person or in writing to our practice address with the address “Mansuroğlu Mah. 1593/1 Sok. Lider Centrio B Blok No:4 D:106 Bayraklı – İzmir” .)

You have the right to request that some of your data be hidden, deleted or destroyed.

DECLARATION OF CONSENT

I have read and understood the prepared Personal Data Information and Consent Text, and I have also been given verbal information on the subject. I have been informed about data security and my application rights,

All my personal data, including my health data, are shared with Dr. within the framework of the above principles. It is recorded, stored and shared in necessary cases by Düzgün Ateş and his employees, and also Dr. Düzgün Ateş can contact me via the mobile devices I have specified below, over the internet or by mail to my address, etc. I ACCEPT WITH MY EXPLICIT CONSENT that you can reach me.

Patient Name and Surname………………………………………………………

Address: E-mail:

Signature:……………………… Date: ……./……./………Time:…..

Write “I understood what I read” in your own handwriting:……………………………………………………………………..

If the patient is under 18 or unconscious:

Patient Relative Name and Surname:………………………………………..

Signature:……………………… Date: ……./……./………Time:…..

The degree of proximity: …………………………..

Write “I understood what I read” in your own handwriting:……………………………………………………………………..

INTERPRETER IF ANY (If the patient has a language / communication problem) 

In my opinion, the information I translated was understood by the patient/patient’s relative.

Name and Surname of the Translator:……………………………….…….

Signature:……………………… Date: ……./……./………Time:…..

Write “I understood what I read” in your own handwriting:……………………………………………………………………..