EXPLICIT CONSENT FORM
Following the entry into force of Law No. 6698 on the Protection of Personal Data (KVKK), published in the Official Gazette on 7 April 2016, Dr. Dt. Ebru Çetinkaya Tokmak (hereinafter referred to as the “Practice/Clinic”), acting in the capacity of Data Controller: Dr. Dt. Ebru Çetinkaya Tokmak, is required to inform you that your personal data and special categories of personal data provided to us by any means, including health data, radiographic images, treatment plans and similar information, may be recorded, stored, updated and anonymised within the framework described below.
Where permitted and/or required by applicable legislation, such data may also be disclosed or transferred to third parties, classified and otherwise processed in accordance with the methods and conditions set out under the KVKK.
Provided that the principles set out under the Law and secondary legislation are complied with, your personal data and special categories of personal data may be processed and transferred to third parties for the purposes and under the conditions described in the KVKK Privacy Notice provided to you.
I hereby give my explicit consent to the processing of all personal data and special categories of personal data, including health data, which I have provided to the Practice/Clinic or which the Practice/Clinic has lawfully obtained through legitimate procedures and processes, within the scope of the Privacy Notice, including the following activities:
- collection, in whole or in part,
- recording,
- storage,
- modification,
- updating,
- periodic review,
- reorganisation,
- classification,
- retention for the period required for the relevant processing purpose or prescribed by applicable legislation,
- sharing, where legally required or necessary for the provision of services, with public institutions and authorities with which the Practice/Clinic cooperates or is legally required to share information,
- sharing with domestic or international laboratories,
- sharing with clear aligner and orthodontic appliance manufacturers,
- sharing with third parties established in Türkiye or abroad where legally required or necessary for the provision of services,
- and transfer of personal data abroad where legally permitted or where required for the provision of services.
I acknowledge and declare that I give my explicit consent to the processing described above and that I have read and understood the KVKK Privacy Notice.
[ ] I Accept
[ ] I Do Not Accept
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