Application Form for Data Controller

1. General Explanations

Under the Personal Data Protection Law No. 6698 ("PDPL"), individuals defined as data subjects ("Applicant") have the right to make certain requests regarding the processing of their personal data as stated in Article 11 of the PDPL.

This application form has been prepared to identify your relationship with Assoc. Prof. Dr. Arzu Akçal Clinic, determine the personal data processed by the Clinic, if any, and provide a complete and timely response to your application in compliance with legal requirements. To ensure the security of your personal data and prevent unlawful data transfers, Assoc. Prof. Dr. Arzu Akçal Clinic may request additional information for identity and authorization verification. The responsibility for providing accurate and up-to-date information in this form lies solely with the Applicant.

In accordance with Article 7 of the Communiqué on the Procedures and Principles for Applications to the Data Controller, if the response to the application is provided in writing, no fee is charged for up to ten pages. For each page exceeding ten, a processing fee of 1 Turkish Lira per page may be charged. If the response is provided on a medium such as a CD or flash drive, the cost of the medium may be requested as a fee.

2. Scope of the Right to Apply Under Article 11 of the PDPL

The Applicant may submit requests to Assoc. Prof. Dr. Arzu Akçal Clinic on the following matters:

Learn whether personal data is being processed,
Request information if personal data has been processed,
Learn the purpose of processing personal data and whether it is used in accordance with the intended purpose,
Learn the third parties to whom personal data has been transferred domestically or abroad,
Request correction of personal data if it has been processed inaccurately or incompletely and request notification of the correction to third parties to whom the personal data has been transferred,
Request the deletion, destruction, or anonymization of personal data in cases where the reasons for processing cease to exist, even if it has been processed in accordance with PDPL and related laws, and request notification of these actions to third parties to whom the personal data has been transferred,
Object to a result against themselves arising from the analysis of processed data exclusively through automated systems,
Request compensation for damages in case of harm due to unlawful processing of personal data.

3. Application Methods

Under Article 13(1) of the PDPL, applications regarding these rights must be submitted to us in writing and signed or via other methods specified by the Personal Data Protection Board ("Board").

To this end, written applications can be made by printing out this form and delivering it:

In person by the Applicant, with proof of identity,
Via a notary public,
With a secure electronic signature or mobile signature, or
Via email sent from the Applicant's email address previously provided to and registered in the system of the Data Controller.

Below are the specific channels for submitting written applications to us:

Application Channels

Application Method	Details to Include	Submission Address
In-person Application (Applicant submits in person with ID)	Write "Request for Information Under Personal Data Protection Law" on the envelope.	Şirinyalı, İsmet Gökşen Cd. Elif Apt No:14/3, 07160 Muratpaşa/Antalya
Application via Notary	Write "Request for Information Under Personal Data Protection Law" on the notification envelope.	Şirinyalı, İsmet Gökşen Cd. Elif Apt No:14/3, 07160 Muratpaşa/Antalya
Application via Mobile Signature or Email (using the registered email)	Write "Request for Information Under Personal Data Protection Law" in the subject line of the email.	info@docdrarzuakcal.com

Assoc. Prof. Dr. Arzu Akçal Clinic may request additional information or take necessary precautions to verify the identity of the Applicant in applications made via email.

Applications submitted to us will be answered in written or electronic form within thirty days from the date of notification or receipt, depending on the nature of the request, as per Article 13(2) of the PDPL.

4. Identity and Contact Information

Applicant's Contact Details:

Details	Provide Information
Name
Surname
ID Number / Passport Number (if foreign)
Phone
Email
Address

Please indicate your relationship with Assoc. Prof. Dr. Arzu Akçal Clinic (e.g., Visitor, Client, Business Partner Employee, Candidate, Former Employee, Employee of a Third-Party Firm, Shareholder, etc.)

Relationship Details

Visitor	Consultant/Patient
Employee	Employee Candidate
Former Employee	Other: ____________________

Unit Contacted in Our Clinic: ____________________________
Subject of Inquiry: ____________________________

5. Subject of the Request

Please provide detailed information about your request under the PDPL:

Subject

Applicant's Name and Surname: ______________________ Signature (if written application): _______________