KVKK Data Subject Application Form | Op. Dr. Volkan Aktemur

Version: October 2026.

Art. 11 of Law No. 6698 on the Protection of Personal Data ("KVKK") gives you certain rights regarding your personal data. To exercise these rights, you may apply to the data controller. This form has been prepared to make your application easier; using it is not mandatory. Any application that contains the mandatory information in section 3 is accepted. Applications must be made in Turkish.

1. Data controller

Information	Details
Data controller	Op. Dr. Volkan Aktemur
Address	Barbaros Mah. Ahlat Sok. No: 1, Varyap Meridian D Blok, Kat: 3, No: 30, 34634 Ataşehir/İstanbul
Email	info@drvolkanaktemur.com

2. Ways to apply

Method	How to apply
Written application	Fill in the form and sign it with a wet signature; deliver it by hand, or send it by postal mail or through a notary to Barbaros Mah. Ahlat Sok. No: 1, Varyap Meridian D Blok, Kat: 3, No: 30, 34634 Ataşehir/İstanbul.
Secure electronic signature or mobile signature	Sign the form with your secure electronic signature or your mobile signature and send it to info@drvolkanaktemur.com.
Your email address in our records	Send it to info@drvolkanaktemur.com from the email address that you have previously given us and that is in our records.

For written applications, the date on which the document is delivered to us is the date of application; for the other methods, it is the date on which the application reaches us.

3. Applicant's information

Fields marked with an asterisk (*) are mandatory.

Information	Your answer
Full name *
Turkish identity number (T.C. kimlik numarası) * (if you are a Turkish citizen)
Nationality and passport number, or identity number if any * (if you are a foreign national)
Place of residence or workplace address for notification purposes *
Email address
Phone number
Fax number

4. On whose behalf are you applying?

☐ I am applying on my own behalf.
☐ I am applying on behalf of someone else (as an attorney-in-fact or a legal representative).

If you are applying on behalf of someone else, fill in the table below and attach the document showing your authority (a power of attorney granting special authority, or a document of parental custody or guardianship):

Information	Your answer
Full name of the person on whose behalf you are applying
That person's Turkish identity number (if a foreign national, nationality and passport number)
Your relationship to that person (attorney-in-fact, parent, guardian, etc.)

5. Your relationship with us

Check the boxes that apply so that we can find the record relating to you.

☐ I visited the website. Date and time of the visit: ……………………
☐ I submitted the appointment form on the website. Approximate date: ……………… Phone number or email I entered on the form: ……………………
☐ I contacted you by WhatsApp, phone or email. Approximate date: ……………… Number or address I used: ……………………
☐ I had an examination or received treatment. Approximate date: ……………………
☐ Other: ……………………………………………

6. Your request

Check what you request (KVKK Art. 11).

☐ I want to learn whether personal data about me are processed.
☐ If my personal data have been processed, I request information about it.
☐ I want to learn the purpose of processing my personal data and whether they are used in accordance with their purpose.
☐ I want to learn which third parties, domestically or abroad, my personal data are transferred to.
☐ I request the correction of my personal data that have been processed incompletely or inaccurately.
☐ I request the deletion or destruction of my personal data within the framework of the conditions in KVKK Art. 7.
☐ I request that the correction, deletion or destruction operations be notified to the third parties to whom my data have been transferred.
☐ I object to a result to my detriment arising from the analysis of my data exclusively through automated systems.
☐ I request compensation for the damage I have suffered because my personal data have been processed unlawfully.
☐ Other.

Explanation of your request:

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

When explaining your request, please do not write health information unless it is necessary. Attach the information and documents relating to your request to your application.

7. Delivery of the response

How would you like to receive the response?

☐ By postal mail, to the address I wrote in section 3
☐ By email, to this address: ……………………

Your application is concluded within 30 days at the latest and, as a rule, free of charge. If the process requires an additional cost, the fee set out in the Communiqué on the Procedures and Principles of Application to the Data Controller (Veri Sorumlusuna Başvuru Usul ve Esasları Hakkında Tebliğ) may be charged: no fee is charged for written responses of up to ten pages, and 1 Turkish lira may be charged for each page above ten pages; if the response is given on a recording medium such as a CD or a USB flash drive, the fee may not exceed the cost of the recording medium. You may be asked for additional information to verify that the application is yours. If your application is rejected, if you find the response insufficient, or if no response is given in time, you may file a complaint with the Personal Data Protection Board within 30 days from the date you learn of the response, and in any case within 60 days from the date of application.

8. Processing of the information in this form

The information you give in this form is processed by the data controller, Op. Dr. Volkan Aktemur, for the purposes of reviewing your application, verifying your identity, responding to you and being able to prove that the application has been responded to, under KVKK Art. 5(2)(ç) (legal obligation) and Art. 5(2)(e) (establishment, exercise or protection of a right); it is shared with authorized institutions and organizations only when required by law, and is kept for 10 years from the date the application is concluded. The details are in the Privacy Notice on the Protection of Personal Data.

9. Declaration and signature

I declare that the information in this form is accurate and up to date, and I request that my application be assessed for the requests I have checked above.

Information	Your answer
Full name
Date
Signature