Privacy Notice and Consent Form

In order for me, as Prof. Dr. Şükrü Yazar, to carry out the services I will provide to you, it may be necessary for us to obtain your personal information and health data and to record and store them, provided that we remain within the limits required by the service to be provided.

Your health data, which we are obliged to record in order to provide you with healthcare services, are regarded by law as special categories of personal data. In this context, under the provision of Article 6(2) of Personal Data Protection Law No. 6698 (KVKK) that ‘The processing of special categories of personal data without the explicit consent of the data subject is prohibited.’, personal health data may be recorded, outside the special conditions specified in the law, only with the explicit written consent of the person concerned; it has therefore become necessary to obtain this consent from you.

INFORMATION NOTICE

1. This consent covers the personal data you give us verbally, in writing, visually or electronically during your examination, together with the personal data you send us through internet and mobile applications or otherwise electronically, or that are obtained at our practice (test results, prescriptions, photographs, videos, camera recordings, etc.).
2. In this sense, the following are regarded as personal data: above all, the personal health data that are necessary for carrying out the services we will provide to you and are obtained for that purpose; identity data such as your name, surname, Turkish identity number (if you are not a Turkish citizen, your passport number or temporary Turkish identity number), place and date of birth, marital status and gender, together with your various identity documents; contact data such as your address, telephone number and e-mail address; financial data such as your bank account number and IBAN; data concerning your health and sex life obtained in the course of medical diagnosis, treatment and care services, such as the medical history in your clinical file, information showing your history of illness, examination data, data on the procedures performed on you, prescription details, photographs, images of any kind, audio/camera recordings, laboratory and imaging results and test results; data relating to private health insurance; and Social Security Institution data, etc.
3. Within the framework of Personal Data Protection Law No. 6698 and the related legislation, these personal data will be recorded only to the extent required by the healthcare service to be provided to you and will be stored in our system/archive ‘…for no longer than the period necessary to fulfil the purposes for which they are recorded’. Your data processed in this context will be protected as professional secrets, their confidentiality will be ensured, and they will not be shared with third parties/institutions/organisations.
4. However, we would emphasise that, in situations where the confidentiality of personal medical records must be restricted in order to protect public health, as in the example of the obligation to notify the competent authorities of communicable diseases set out in Article 58 of Public Health Law No. 1593, or in cases of legal obligation such as the duty to report a crime, it may be necessary to notify the competent authorities of your personal data, limited solely to that purpose and in a proportionate manner.
5. Requests from public institutions, judicial authorities and other official bodies for your data to be passed to them will be assessed against the following elements: the purpose of the request; whether the data requested correspond to the purpose to be achieved; whether this can be demonstrated in concrete terms; whether passing on your data without anonymisation is the only way to achieve the stated purpose; and whether the transfer of the data is necessary in a democratic society. Requests for the transfer of data that do not satisfy all of these elements will not be fulfilled.
6. With regard to your data recorded by us, in particular under the Convention for the Protection of Individuals with regard to Automatic Processing of Personal Data (Council of Europe Convention No. 108), Article 8 of the European Convention on Human Rights, Article 20 of the Constitution and Personal Data Protection Law No. 6698, you have the right:

• to learn whether your personal data are being processed and the scope of the data processed,
• if your personal data have been processed, to obtain information about this, to access those data and to obtain copies of them,
• to learn the purpose for which your personal data are processed and whether they are used in accordance with that purpose, and whether they have been transferred to a third person or institution in Türkiye or abroad, and to request that changes to your personal data be notified to the persons or institutions with whom the data have been shared,
• to request the correction of your personal data if they have been processed incompletely or inaccurately, (You have been informed that this right may be exercised by applying in person or in writing to our practice at Harbiye Mah. Valikonağı Cad. Marmara Apt. No: 16 Floor: 1 Unit: 2, or by a request sent to our e-mail address info@sukruyazar.com from the personal e-mail address of the data subject stated below.)
• to request that some of your data be concealed, erased or destroyed.

II. DECLARATION OF CONSENT

That I have read and understood the Personal Data Information and Consent Text prepared by Prof. Dr. Şükrü Yazar, and that I have also been given verbal information on the matter,

That I have been informed of the purposes for which my personal data are processed, the methods and legal grounds of their collection, my rights regarding the protection of my personal data, the mandatory cases in which my data may be transferred, data security and my rights of application, as set out in detail in the Personal Data Information and Consent Text,

That all my personal data, including my health data, be recorded and stored by Dr. Şükrü Yazar and his staff within the framework of the principles above, and shared in the mandatory cases listed,

In addition, that my data be shared, limited to the purpose, by my doctor with colleagues for consultation where my medical diagnosis and treatment so require, or with product supplier companies where a product specific to me needs to be purchased,

And furthermore, that Prof. Dr. Şükrü Yazar and his staff may contact me by mobile means (my telephone:………………………………), via the internet (my e-mail address:……………………………..) or at my address (my address:……………………………………………………………….. by post, etc.), I ACCEPT WITH MY EXPLICIT CONSENT.

*Under the Patient Rights Regulation, you may request that a copy of this form be given to you.

Patient’s Name and Surname………………………………………………… Signature:…………Date: ……./……./………Time:….. Write “I have read and understood” in your own handwriting:…………………………………………………………………..

If the patient is under 18 years of age or unconscious: Patient’s Relative’s Name and Surname:……………………………………….. Signature:…………Date: ……./……./………Time:….. Relationship to the Patient: ………………………….. Write “I have read and understood” in your own handwriting:…………………………………………………………………..

INTERPRETER, IF ANY (if the patient has a language/communication problem) In my opinion, the information I have interpreted has been understood by the patient/patient’s relative. Interpreter’s Name and Surname:………………………….……. Signature: …………Date: …../……./……… Time:……