Explicit Consent Form for the Processing of Personal Data

1. COMPANY INFORMATION OF THE DATA CONTROLLER
Name: Smile Antalya Oral and Dental Health Private Health Services Trade Ltd. Sti. (Smile Antalya Ağız ve Diş Sağlığı Özel Sağlık Hizmetleri Tic. Ltd. Şti. )
Address: Kemerağzı Mah. Yaşar Sobutay Blvd. Tekin Plaza No:304/23 Aksu/Antalya
Tax No: 772 127 2034
Phone: +90 544 733 77 71
Registered Email (KEP) Address: smileantalya@hs01.kep.tr

2. SUBJECT OF CONSENT
This explicit consent form, prepared by Smile Antalya Oral and Dental Health Private Health Services Trade Ltd. Sti. (COMPANY), is arranged as an annex and an integral part of the “Illumination Text” and the contract signed by the parties in accordance with the COMPANY Policy determined in compliance with the Personal Data Protection Law No. 6698 (KVKK) and the General Data Protection Regulation (GDPR).

A. For Patients Who Will Be Examined or Treated:

1. Your Identity Information:
   If you are a Turkish citizen; your Name, Surname, Turkish ID Number, Gender, Date of Birth, and ID Number
   If you are not a Turkish citizen; your Temporary ID Number or Passport Number

2. Your Contact Information:
   Your address in Turkey, GSM Number, Email Address
   (The data listed in items 1 and 2 above are processed by the COMPANY for the purposes of creating and tracking visitor and patient records, maintaining COMPANY statistics, ensuring customer satisfaction, planning and managing internal operations by COMPANY management, conducting analyses to improve health services by quality, patient experience, and information systems departments, and ensuring the accuracy and currency of data collected from visitors, patients, personnel, doctors, and business partners with whom the COMPANY has business relations.)

3. Voice recordings of your calls made with our call center that serves you and your relatives as our valuable patients within the COMPANY,

4. Your personal data and location information in the forms and surveys you filled out on the website https://smileantalya.com opened on behalf of the COMPANY,

5. Personal data you shared when you reached us via email, call center, or other channels.
   (The data listed in items 3, 4, and 5 above are processed for the purposes of ensuring customer satisfaction and meeting requests, maintaining COMPANY statistics, planning and managing internal operations by COMPANY management, conducting analyses to improve health services by quality, patient experience, and information systems departments within the COMPANY, and ensuring the accuracy and currency of data collected from visitors, patients, personnel, doctors, and business partners with whom the COMPANY has business relations.)

6. Your CCTV footage and voice recordings taken during your visits related to examination and treatment processes carried out within the COMPANY, and voice recordings of your calls made with our call center if you contacted the hospital on behalf of the patient,
   (These are processed for the purposes of ensuring the security of COMPANY assets and/or resources, ensuring the security of the company premises, and ensuring customer satisfaction and meeting requests.)

B. For Employees and Doctors:

7. For the planning and execution of talent – career development activities for employees and doctors working within the COMPANY, the following information is processed during job application: your name, surname, gender, undergraduate and associate degree education information, area of expertise, GSM number, email address, foreign language proficiency level, CCTV footage,
   (if you apply for a job at the COMPANY, during recruitment and afterward; monitoring the compliance of experience, knowledge, and skills with the required criteria, ensuring the security of COMPANY assets and/or resources, ensuring the execution of contracts signed between parties and the control of authorizations of signatories, planning and managing internal operations by COMPANY management, conducting analyses to improve health services by quality, patient experience, and information systems departments within the COMPANY, carrying out necessary operational activities within the COMPANY, ensuring human resources management, taking necessary steps to make, implement and execute commercial decisions, ensuring the security of COMPANY assets and/or resources, and ensuring the security of company premises.)

This consent form is prepared to obtain the explicit consent of the data subject (relevant person) regarding the processing, storage, transfer, security of your personal data provided to the COMPANY, and the mutual rights and obligations during this process, in accordance with the purposes specified in the “Illumination Text.”

4. APPROVAL

As the data subject (relevant person), I acknowledge, declare, and undertake that I have been duly informed in accordance with the provisions of the relevant legislation and have read and understood every page of the text completely without any doubt, regarding the collection, processing, modification and updating, periodic control, storage in the database, storage of backups, protection, and restriction of access to my personal and/or special categories of personal data provided to the COMPANY for the purposes specified in the “Illumination Text” and stated above, and their sharing with relevant public institutions and organizations and third parties as necessary and transferring to business partners with whom the COMPANY has a business relationship.

3. YOU HAVE THE RIGHT TO WITHDRAW YOUR EXPLICIT CONSENT.

You can personally deliver it to the address Kemerağzı Mah. Yaşar Sobutay Blvd. Tekin Plaza No:304/23 Aksu/Antalya,

You can send it with a secure electronic signature or mobile signature to the address smileantalya@hs01.kep.tr, or via your registered email address in our system.

And you can withdraw your explicit consent for the processing of your personal data from the CONTACT US section on https://smileantalya.com.

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Patient’s Name Surname: _________________________ Signature: _________

Date: _______________

Write “I give my explicit consent”:

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What is your relationship to the patient if the patient is under 18 years old?

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Relative’s Name Surname: _______________________________

Signature: _________ Date: ________

Write “I give my explicit consent”:

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INTERPRETER

Name Surname: _________________________________

Signature: _______________ Date: _____________

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I have been informed by the patient/relative of the patient that all the information I have translated has been understood. Explicit consent has been given. (One copy of the form will be given to you as required.)