KVKK Application Form
Personal Data Protection Application Form
Personal data owners ("Applicant") defined as relevant persons in the Personal Data Protection Law No. 6698 ("KVKK") are granted the right to make certain requests regarding the processing of their personal data in accordance with Article 11 of the KVKK.
This form is based on Article 11 of the KVKK. It has been prepared to facilitate your exercise of your right to receive information by applying to EHEALTH TEKNOLOJİ A.Ş. (“Company or Data Controller”) in accordance with the article.
1. Application Procedure
In accordance with Articles 11 and 13 of the KVKK; You can submit your requests regarding the implementation of KVKK to our Company, which is the data controller, in writing by filling out this form or by other methods determined by the KVK Board:
- By applying in person to the address of Kızılırmak Mahallesi Dumlupınar Bulvarı Next Level No: 3A/10 Çankaya/ANKARA with a signed copy of this personal data subject application form,
- By sending a signed copy of this personal data subject application form to the address of Kızılırmak Mahallesi Dumlupınar Bulvarı Next Level No: 3A/10 Çankaya/ANKARA via registered mail,
- You can send a signed copy of this personal data owner application form with an electronic signature to the e-mail address ehealthteknolojia.s@hs01.kep.tr or info@ehealth.com.tr.
2. Applicant Contact Information:
The information requested with this form is necessary to accurately identify you, to conduct detailed research on your request, and to notify you of the result of your application (“Purpose”) and can only be processed for this purpose. Therefore, please submit your information accurately and completely. Your requested personal data will not be used in any way other than fulfilling the purpose.
+ NumberPlease specify your request within the scope of KVKK in detail:
………………………………………..
3. Finalization of the Applicant's Request
Depending on the nature of your request, your applications will be responded to in writing or electronically, according to your selection in this application form, within 30 (thirty) days at the latest from the date your request reaches us. If you have a preference regarding the delivery of the application result by post, e-mail or another method, please indicate below.
- I want it to be sent to my address.
- I want it to be sent to my e-mail address. (We will be able to respond to you faster if you choose the e-mail method.)
- I want to receive it in person.
4. Appendices
Documents supporting your request, if any, must be added to the form.
- If you apply as an individual, attach a copy/photocopy of the documents proving your identity (identity card, driver's license, passport, etc.) to the form.
- If the application is made through an attorney, a copy of the power of attorney containing the special authority must be submitted to our Company as an attachment to the form.
5. Personal Data Owner Declaration
If you sign this form and submit it to our Company, you declare that you accept, declare and undertake that the information and documents you have provided to us in this application are accurate, up-to-date and belong to the data owner you are applying for as your representative, in the evaluation and conclusion of this application for information you have made in accordance with KVKK within the framework of the request/requests you have stated above, and that you know that our Company will not have any liability if the information regarding your requests you submit within the scope of the form is not accurate and up-to-date or an unauthorized application is made. you are becoming.
6. Personal Data Owner's Right to Complain to the Board
In cases where the application is rejected, the response is found to be insufficient, or the application is not responded to in due time, the personal data owner may file a complaint with the KVK Board within 30 (thirty) days from the date of learning our Company's response, and in any case within 60 (sixty) days from the application date.
There will be no complaints to the KVK Board unless an application is made to our company.
Your application will be finalized free of charge, but if the process requires an additional cost, the fee in the tariff determined by the KVK Board may be charged.
Applicant (Personal Data Owner/Representative)
Name-Surname:
Application Date:
Signature: