COSTUMER EXPLICT CONSENT FORM

By signing this form;

 

I hereby consent to sharing personal data with LAL YAPI TUR. SEY. ORG. SAN. VE TİC. A.Ş. (hereinafter referred to as “CLINIC MONO”) in accordance with the purposes listed below and to the processing and transfer of this information with this Form in accordance with the Personal Data Protection Law No. 6698.

 

Data that I consent to processing and transferring;

 

  1. ID datas such as name, surname, Turkey Republic ID number, passport informations, in case of being a foreign citizen passport number and temporary Turkey Republic ID number, birthplace and date, marital status, gender and the photocopy of the ID Card or Driving License,
  2. Contact and location data such as address, location information, phone number, e-mail address,
  3. Financial data such as bank account number, IBAN number,
  4. Your health and sexual life data obtained during the execution of medical diagnosis, esthetics, treatment and care services such as your own laboratory and imaging results, test results, examination data, photographs of your body and video records, prescription information, blood type, past treatment informations, in order to be monitored in the file and to get service,
  5. Responses and comments that I share in physical and / or digital media in order to evaluate your services,
  6. Closed circuit camera system image and sound recording taken during the visit to Doctor’s office, clinic and hospitals,
  7. Written notes and voice conversation records kept in case of contacting our Call Center,
  8. Data regarding private health insurance and Social Security Institution data for the purpose of financing and planning health services,
  9. Vehicle license plate data if the parking lot and valet service is used,
  10. Browsing information, IP address and medical documents, surveys, form information, location and contact data that  have transmitted with consent, which are obtained during the use of our website and mobile application,
  11. Accommodation data that is requested In case transportation and accommodation services are used, such as travel, flight, ticket information and accommodation data requested for the hotel, hostel, house etc. where you will stay in,

Your collected personal data are stipulated by Law No. 6698 and GDPR, a) Compliance with the law and the rules of honesty, b) Being accurate and up-to-date when necessary c) Being processed for specific, clear and legitimate purposes, d) Being linked, limited and proportionate to the purpose for which they are processed, e) In accordance with the basic principles of preservation for the period required by the relevant legislation or for the purpose for which they are processed; Law No. 6698;

 

Article 5/1 within this framework “Obtaining the explicit consent” of the Data Subject

Article 5/2 (a) “It is expressly permitted by any law”

Article 5/2 (c) “It is necessary to process the personal data of parties of a contract, provided that the processing is directly related to the execution or performance of the contract”

Article 5/2 (ç) “It is necessary for compliance with a legal obligation which the controller is subject to”

Article 5/2 (f) “It is necessary for the legitimate interests of the data controller, provided that the fundamental rights and freedoms of the data subject are not harmed” it will be processed for the following purposes:

I give my explicit consent and permission to the processing of my personal data for the following purposes and to its transfer to third parties inside and outside the company;

 

Fulfillment of the purpose required for the execution of the customer contract, especially;

 

  1. Fulfilling our obligations under the contract with our customer,
  2. Carrying out the necessary work by our business departments  to benefit the data subject from the products and services offered and carrying out the relevant business processes,
  3. Planning and execution of the activities required for the promotion and recommending of the products and services offered to the data subject by customizing them according to the likes, usage habits and needs of the data subject, sending commercial messages,
  4. Carrying out the necessary work by our relevant business units for the realization of the commercial activities that are being carried out and carrying out the related business processes,
  5. Establishing contractual processes such as service and after-service support, execution and follow-up of all necessary transactions, execution of contract processes, planning and execution of operational processes,
  6. The operation and follow-up of all kinds of processes in order to fulfill the obligations regarding after-service support and to carry out an effective service process
  7. Conducting accounting and financial transactions, including service-related invoicing activities, performing risk management,
  8. To be able to perform evaluation, analysis and risk management studies regarding customers within legal limits,
  9. Fulfilling the guaranty obligation, monitoring the processes of the products covered by the guaranty,
  10. Conducting customer relations and monitoring corporate governance activities
  11. Improving and developing the services offered, determining and implementing commercial and business strategies,
  12. Maintaining business and operations, carrying out activities and procedures
  13. Managing risk, ensuring business continuity, following up contract processes or legal requests,
  14. Planning information security processes, ensuring the security of our website, establishing and managing information technology infrastructure,
  15. Responding to the demands of customers, visitors and other people who convey their complaints and requests through different channels, including our website, identifying and resolving their problems and communicating with the data subject in these processes,
  16. Ensuring the legal and commercial security of people who are in business relations with the products and services offered,
  17. Planning and monitoring the work carried out with authorized dealers / service / manufacturers, business partners, dealers or suppliers,
  18. Follow-up and execution of legal processes and communication processes with official institutions,
  19. Resolving legal disputes that may arise in the future,
  20. Ensuring workplace safety,
  21. Execution of protection of public health, preventive medicine, medical diagnosis, esthetics , treatment and care services,
  22. Sharing the requested information with the Ministry of Health and other public institutions and organizations in accordance with the relevant legislation,
  23. Fulfillment of legal and regulatory requirements,
  24. Financing of health services, payment of the expenses of examination, diagnosis and treatment, sharing
  25. the requested information with private insurance companies within the scope of Eligibility Verification
  26. To be informed about your appointment through the Call Center and Digital Channels,
  27. Confirmation of your identity by Patient Services, Healthcare Professionals and Call Center departments,
  28. Planning and managing the internal workings of the doctor’s office, clinic and hospital,
  29. Monitoring and preventing abuse and unauthorized transactions by the Audit and Information Systems departments,
  30.  Billing for our services by the Patient Services, Financial Affairs and Marketing departments
  31. Responding to all my questions and complaints by the Call Center departments regarding the health services provided / to be given to me
  32. Reminding of the process periods related to continuous medical procedures,
  33. Taking all necessary technical and administrative measures within the scope of data security of our Clinic’s systems and applications by the Information Systems departments,
  34. Providing marketing, promotion, participation in campaigns and campaign information by Call Center departments, designing and communicating special content, tangible and intangible benefits on web and mobile channels,
  35. Informing the public through social media and other communication tools,
  36. Making advertisements on the quality and processes of the service provided, by sharing the photographs and video recordings showing the pre and post situation regarding the service and medical procedure in various media.
  37. Measuring, increasing and investigating patient satisfaction.

 

  •  Transfer of Your Personal Data

Your personal data can be transferred to public institutions (such as ministries and Presidency boards) within the scope of the purpose and limitations stipulated by the law, if requested in cases clearly stated in the laws.

Your personal data can be transferred to;

  • In order to fulfill the legal obligation, authorized official institutions and organizations and persons authorized by law,
  • To the relevant judicial authorities and authorized lawyers in order to carry out or follow up the judicial processes,
  • To authorized service, professional consultants, accountants and auditors from which the Company provides services, for the development of business processes, execution of definition and marketing activities, risk management, planning of sales and after-sales support processes, fulfillment of contractual obligations
  • Occupational health and safety institutions and experts that we receive service to fulfill our legal obligations
  • To the private and public institutions, physicians, hotels, organization companies and banks with which the Company has commercial, administrative or contractual relations within the scope of performance of contractual obligations, establishment of the right, fulfillment of legal obligations and legitimate interests.
  • Sözleşmesel yükümlülüklerin ifası için taşıma ve dağıtım hizmeti veren kargo, motokurye ve lojistik firmalarına, Shipping, motorcycle courier and logistics companies that provide transportation and distribution services in order to fulfill contractual obligations
  • To Group companies in order to carry out our internal relations

 

  1. Methods of Obtaining Personal Data

Although the methods of collecting personal data may vary depending on the service provided by CLINIC MONO and the commercial activities of CLINIC MONO, your personal data, with all contracts / information forms and other documents regarding transactions issued with your approval and / or signature; they can be collected with automatic or non-automatic methods, via website, social media channels, mobile applications, security cameras and similar means. It can be verbal, written or electronic.

 

Your Rights as a Data Subject listed in Article 11 of Law No. 6698 and GDPR

The rights of real persons, whose personal data are processed in accordance with Article 11 of Law No. 6698 are as follows;

  1. Learning whether personal data is processed,
  2. If personal data has been processed, to request information regarding this,
  3. Learning the purpose of processing personal data and whether they are used appropriately for their purpose,
  4. To learn whether personal data are transferred domestically or abroad, and to know the third parties to whom it is transferred,
  5. To request correction of personal data in case of incomplete or incorrect processing and to request notification to be made about the correction to third parties to whom personal data have been transferred,
  6. Although it has been processed in accordance with the provisions of Law No. 6698 and other relevant laws, to request the deletion or destruction of personal data in the event that the reasons requiring its processing disappear, and to request notification to be made within this scope to third parties to whom personal data have been transferred,
  7. Object to the occurrence of a result that is disadvantageous of analyzing the processed data exclusively through automated systems,
  8. To request the compensation of the damage due to unlawful processing of personal data
  9. You can also withdraw your explicit consent given within the scope of this text. However, if there are other reasons for compliance with the  Law No. 6698, your personal data processed for these reasons will continue to be processed in accordance with the principles stipulated in the law. Therefore, if you withdraw your explicit consent, the processing of your data processed solely based on your explicit consent will be terminated immediately, but your personal data processed in line with both your explicit consent and other legal compliance reasons stipulated in law numbered 6698 will continue to be processed within the framework of legal provisions. If you withdraw your explicit consent, a detailed information text will be sent to you in accordance with the principles in the law numbered 6698.

 

You can transmit your application for your rights listed above, with your request which contains the necessary

information identifying your identity and your explanations about your right to use the rights specified in Article

11 of Law No.6698 with following methods: You can fill in the Data Subject Application Form at ; www.clinicmono.com.tr and send a signed copy of the form to Adalet Mah. Manas Bulv.  Folkart Towers A Kule No:47/B D:2009, Bayraklı/Izmir by hand with documents identifying you, you can send it via notary or other methods specified in the Law No. 6698., or you can send the form to [email protected] with a secure electronic signature.

 

Depending on the nature of the request, the request will be concluded free of charge as soon as possible, within thirty (30) days at the latest. However, if the transaction requires an additional cost, we will charge the fee in the tariff determined by the Board of Protection of Personal Data.

Applications can be made in English or Turkish. In the application there must be name, surname and signature if the application is written, Turkey Republic ID number for Turkey citizens, on the other hand, nationality, passport number / identity number, place of residence or workplace address for notification, e-mail address, telephone or fax number and subject of request for foreigners. 

In the application containing the explanations about the right that the relevant person has and that he / she will make in order to exercise the above-mentioned rights and that he / she has requested to use; the requested matter should be clear and understandable, the requested subject must be related to the person. If he / she is acting on behalf of someone else, he / she must be specially authorized in this regard and must document his / her authority, identification and address information and documents proving identity must be attached to the application. 

We declare in the capacity of “Data Controller” within the scope of Law No. 6698 and GDPR.

Regards,

LAL YAPI TUR. SEY. ORG. SAN. VE TİC. A.Ş. 

Adress: Adalet Mah. Manas Bulv.  Folkart Towers A Kule No:47/B D:2009, Bayraklı/Izmir

Phone: 0549 675 10 17 

E-Mail: [email protected]

 

If you accept; 

Please write in your handwriting “I understood what I read and I have been informed about the processing and transfer of my personal data and I have explicit consent”:

………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………

I do not accept 

 

Data Subject’s 
Name Surname :
Date :
Signature :
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