Application Form

KVKK Application Form


Personal data owners defined as the data subject in the Law on the Protection of Personal Data No. 6698 (hereinafter referred to as the “Applicant”) have been granted the right to make certain requests regarding the processing of their personal data in Article 11 of the KVK Law.

In accordance with the first paragraph of Article 13 of the KVK Law; Applications regarding these rights to our Company, which is the data controller, must be submitted to us in writing or by other methods determined by the Personal Data Protection Board (“Board”).

In this context, applications to be made to our clinic in “written” form, by printing out this form; upon the applicant's personal application to our clinic located at Rüya Sokak No 15 Ataşehir, through a notary,

By sending it to the email address signed by the applicant with the "secure electronic signature" defined in the Electronic Signature Law No. 5070, may be forwarded to us.

Moreover; after the other methods to be determined by the board are announced, our clinic will announce how the applications will be received through these methods.

Your applications submitted to us will be answered within thirty days from the date of receipt of your request, in accordance with the second paragraph of article 13 of the KVK Law, depending on the nature of the request. our answers will be delivered to you in writing or electronically in accordance with the provisions of article 13 of the relevant KVK Law.


In the processing of personal data, in order to protect the fundamental rights and freedoms of individuals, especially the privacy of private life, and to regulate the obligations and procedures and principles to be followed by real and legal persons who process personal data, within the scope of the Law No. 6698 on the Protection of Personal Data (“KVKK”), Dr. Burak AKSU and Dr. Irem Sakarya Aksu, as data controller, your personal data can only be used for the purposes and scope described below, within the scope of the Basic Law on Health Services No. 3359, Decree Law No. 663 on the Organization and Duties of the Ministry of Health and Affiliates, Regulation on Private Practices, No. 6698 It can be processed in accordance with the Law on the Protection of Personal Data, the Regulation on the Processing and Privacy of Personal Health Data, the regulations of the Ministry of Health and other relevant legislation.