REGENE PRIME PERSONAL DATA APPLICATION FORM

GENERAL EXPLANATIONS

Your Rights

According to Article 11 of the Law No. 6698 on the Protection of Personal Data (the “Law”), personal data subjects (hereinafter referred to as the “Applicant”) have the following rights:

– To learn whether their personal data is being processed (KVKK 11.1.a),
– If their personal data is being processed, to request information about it (KVKK 11.1.b),
– To learn the purpose of processing personal data and whether it is being used in accordance with these purposes (KVKK 11.1.c),
– To know the third parties to whom their personal data has been transferred, both domestically and abroad (KVKK 11.1.ç),
– To request correction of personal data if it is incomplete or inaccurate (KVKK 11.1.d),
– To request deletion or destruction of personal data under the conditions specified in Article 7 of the Law (KVKK 11.1.e),
– To request notification of the transactions performed under (d) and (e) to third parties to whom personal data has been transferred (KVKK 11.1.f),
– To object to any negative consequences that result from the analysis of personal data exclusively through automated systems (KVKK 11.1.g),
– To request compensation for damages in case of loss due to unlawful processing of personal data (KVKK 11.1.ğ).

You can submit your requests under this scope to Regene Prime using the procedures and methods detailed below. To provide you with faster and more accurate information and to take more effective action based on your requests, you can complete and submit the ready-made Application Form prepared for you.

According to Article 13 of the Law and Article 5 of the Communiqué on Application Procedures and Principles to the Data Controller (Official Gazette No. 30356, dated 10/03/2018), applications regarding these rights must be submitted in writing in Turkish or through other methods determined by the Personal Data Protection Board (the “Board”).

Application Channels

Below are the details on how written applications can be submitted to us.

APPLICATION METHOD

ADDRESS FOR SUBMISSION

INFORMATION TO BE INCLUDED IN THE APPLICATION

Written Application

(Submission in person with identity verification document)

KÜÇÜKBAKKALKÖY MAH. DEFNE SK. FLORA NO:1/365, ATAŞEHİR/ İSTANBUL
On the envelope:
“KVKK Information Request” should be written.

KÜÇÜKBAKKALKÖY MAH. DEFNE SK. FLORA NO:1/365, ATAŞEHİR/ İSTANBUL
The subject line of the notification should state:
“KVKK Information Request”

Application Procedure

According to the Communiqué on Application Procedures and Principles to the Data Controller (Official Gazette No. 30356, dated 10/03/2018), your application should include: (a) your name, surname, and signature, (b) Turkish citizens’ ID number, or for foreigners, nationality, passport number, or ID number if available, (c) your residential or workplace address, (ç) if available, your email address, phone number, and fax number, (d) the subject of your request and any related information and documents.

If you are applying on behalf of someone else, please include documents proving that you are authorized to make the request (such as guardianship documents or a power of attorney clearly stating the authority to request on behalf of the data subject).

You may use the following Application Form for your personal data requests. To address legal risks arising from unlawful and unjust data sharing and to ensure the security of your personal data, we reserve the right to request additional documents and information (e.g., copies of ID cards or driver’s licenses). Regene Prime will not be liable for any incorrect information or unauthorized requests due to inaccurate information or unauthorized application.

Your applications will be responded to in writing free of charge within thirty days from the date the request is received, in accordance with Article 13, Paragraph 2 of the Law. However, no fee will be charged for responses up to ten pages, and a processing fee (1 TL) determined by the Board will be charged for each page exceeding ten pages.

APPLICATION FORM

Applicant’s Information

Name and Surname: ………………………………………………

ID Number: ………………………………………………

For Foreigners, Nationality

and Passport Number: ………………………………………………

Address for Notification

and/or Residence: ………………………………………………

Email Address for Notification: ………………………………………………

Phone Number: ………………………………………………

If applying on behalf of someone else:

Explanations: ………………………………………………

Applicant’s Relationship with Regene Prime

Patient
Patient’s Relative
Employee
Business Partner
Former Employee
Website User
Visitor

Reason and time of visit: …………….……………………………………….

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Other: …………………………………………………………………….………..
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Please specify your request under the Law in detail.

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Additional Information and Documents to Attach to the Application Form

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Please choose the method for receiving the response to your application:

I would like it to be sent to the address I specified below by mail:
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I would like it to be sent to the address I specified below by email:
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I would like to collect it in person.

In accordance with my requests specified above, I kindly request that my application to Regene Prime be evaluated and that I be informed in accordance with Article 13 of the Law.

I declare and undertake that the documents and information I have provided in this application are accurate, current, and belong to me.

Applicant

Name and Surname:

Application Date:

Signature: