Consent Form Regarding the Processing of Personal Data

Physician: Dr. Elad Azizli

By the physician; The protection and processing of your personal data that you share within the scope of all health services, including examination, diagnosis-treatment, surgery, and all kinds of personal information obtained as a result of health services will be carried out within the scope of the Personal Data Protection Law No. 6698 and the relevant legislation. Your personal data that you share with the physician will be processed as specified in this Consent Form Regarding the Processing of Personal Data.

Within the scope of this Consent Form and Law No. 6698, “Personal Data” (any information relating to an identified or identifiable natural person) shall mean all kinds of up-to-date information, including your population information, your TR ID number, patient interview form, and information in the consent form. . This information can be collected verbally, verbally, in writing and electronically by physicians and their employees or related health institutions.

It states that your personal data will be processed, recorded, stored, preserved, updated when necessary, shared and transferred by the physician who has the title of Data Controller as defined in the Law No. 6698. We hereby declare that any action to be taken on it will be considered as the processing of personal data.

All digital communication tools such as written, audio, visual press publications, internet, website, e-mail, message, forum by the physician regarding their professional issues in terms of evaluating and sharing the patient satisfaction of the pre- and postoperative visual records that do not contain the identity information of the personal data owner. It can store and process it to be used in all social media applications such as facebook, instagram, twitter, etc.

Within the framework of all these explanations, I accept that I have read and understood this information and consent form and that I have the following statement taken in this way. In accordance with the Law on the Protection of Personal Data No. 6698, my personal and/or private personal data; to obtain, record, store, change, update, periodically control, rearrange, classify, store for the period required for the purpose for which they are processed or for the period stipulated in the relevant law, in case of legal or service-related actual requirements, together with the physician. to share with the people they work with or the health institutions and organizations that they are legally obliged to, to share visual records without including identity information in digital communication tools and social media applications; I consent to the transfer of my personal information, both transferred by me and learned within the scope of health service, to the relevant physicians and employees, having knowledge without hesitation about the subject.

“Personal Data Owner” Patient Name Surname:

Date:

Signature: