APPLICATION FORM TO THE DATA CONTROLLER
Article 11 of the Turkish Personal Data Protection Law No. 6698 ("KVKK") grants natural persons whose personal data are processed ("Data Subjects") certain rights which may be exercised by applying to the data controller. Applications concerning these rights shall be submitted to the data controller pursuant to Article 13 of the KVKK and the Communiqué on the Procedures and Principles of Application to the Data Controller ("Communiqué"). This form has been prepared to enable applications to TREATX Medikal Turizm Sanayi ve Ticaret A.Ş. ("TreatX" or the "Company") to be processed completely and promptly. Use of this form is not mandatory; any application containing the information required under the Communiqué will be evaluated.
You may submit your application by any of the following methods (Communiqué, Article 5/1):
Method | Address / Channel | Important Notes |
Application through the Platform | The KVKK application screen in your account or the support channel (Contact → Privacy / Data Protection Request) | Being logged into your account serves as identity verification; no separate identity document is requested. |
Written application (in person, by post/courier or through a notary public) | TREATX Medikal Turizm San. ve Tic. A.Ş., Adalet Mah. Manas Blv. No: 47B, İç Kapı No: 2809, Bayraklı/İzmir, Türkiye | The form must bear a wet-ink signature. Write "Information Request under the Personal Data Protection Law" on the envelope. For in-person applications, an identity document must be presented. |
Registered Electronic Mail (KEP) | treatxmedikal@hs03.kep.tr | Write "Information Request under the KVKK" in the subject line. |
Secure electronic signature or mobile signature | info@treatx.health or treatxmedikal@hs03.kep.tr | Sign the form using a secure electronic signature or mobile signature and attach it to the e-mail; use the same subject line. |
E-mail address registered in the Company’s systems | info@treatx.health | The application must be sent from the e-mail address previously provided to the Company and registered in our systems. If an application is received from an unregistered address, you will be informed about valid application methods and identity verification. |
The application date is the date on which the document is served on the Company for written applications, and the date on which the application reaches the Company for all other methods (Communiqué, Article 5).
TreatX is a marketplace; healthcare services are provided by the Service Provider (hospital, clinic or physician) selected by you. Accordingly, the data controller may differ depending on the data to which your request relates:
If your request concerns | Data Controller | Where to Apply |
Account and membership information; quotation, booking and payment transaction records; cancellation and refund records; in-Platform messaging records; marketing permissions; consent and cookie preference records; and data relating to Service Provider representatives, employees, job applicants and visitors | TreatX | This form |
Request files uploaded to the Platform and copies of health data held on the Platform | TreatX and the relevant Service Provider (according to their respective roles) | This form — TreatX will resolve the part falling within its own role and, with your knowledge, forward the part falling within the Service Provider’s responsibility to that Service Provider. |
Treatment files, examination and test results, imaging records, discharge summaries, informed consents and other patient records | The Service Provider from which you received healthcare services | Apply directly to the Service Provider; TreatX may assist by providing the relevant contact details. |
Payment card data and records relating to payment services | Payment Service Provider (currently iyzico) | Apply to the Payment Service Provider; your card data are not stored in TreatX systems. |
Fields marked (*) are mandatory under Article 5/2 of the Communiqué. If the application is submitted on behalf of the Data Subject, this section must contain the Data Subject’s information; the representative’s information must be entered in Section 8.
Field | Information |
Full Name (*) | |
Turkish ID Number (*) — for Turkish citizens | |
Nationality and Passport Number or Identity Number (*) — for foreign nationals | |
Residential or business address for service of notices (*) | |
E-mail address for notifications | |
Telephone / fax number | |
E-mail address registered on the Platform (if different from the above) | |
Language of correspondence | ☐ Turkish ☐ English |
Please indicate your relationship so that your data can be identified promptly (more than one option may be selected):
Selection | Relationship |
☐ | Service Recipient (member / patient) |
☐ | Relative / companion of a Service Recipient |
☐ | Service Provider representative / physician / employee — Organisation: .................... |
☐ | Platform visitor (not a member) |
☐ | Employee |
☐ | Former employee — Employment period: .................... |
☐ | Job applicant — Position / application date: .................... |
☐ | Office visitor |
☐ | Supplier / business partner representative or employee — Company: .................... |
☐ | Other: .................... |
Relevant transaction information (if any) | Details |
Booking / request number, date range, unit you communicated with |
Please tick the box corresponding to your request (more than one option may be selected):
Selection | Subject of Request | Legal Basis |
☐ | I would like to learn whether my personal data are being processed. | Art. 11/1-(a) |
☐ | If my personal data are being processed, I request information regarding such processing. | Art. 11/1-(b) |
☐ | I would like to learn the purpose of processing my personal data and whether they are used in accordance with that purpose. | Art. 11/1-(c) |
☐ | I would like to know the third parties to whom my personal data have been transferred in Türkiye or abroad. | Art. 11/1-(ç) |
☐ | I believe my personal data have been processed incompletely or inaccurately and request rectification. (Please specify the information to be corrected and the correct information in Section 7 and attach supporting documents, if any.) | Art. 11/1-(d) |
☐ | I request the deletion or destruction of my personal data within the framework of the conditions set out in Article 7 of the KVKK. | Art. 11/1-(e) |
☐ | I request that the rectification of my incomplete or inaccurate personal data be notified to third parties to whom my data have been transferred. | Art. 11/1-(f) |
☐ | I request that the deletion or destruction of my personal data be notified to third parties to whom my data have been transferred. | Art. 11/1-(f) |
☐ | I object to the occurrence of a result against me arising from the analysis of my processed data exclusively by automated systems. (Please specify the result you object to in Section 7.) | Art. 11/1-(g) |
☐ | I request compensation for damage I have suffered as a result of the unlawful processing of my personal data. (Please specify the nature, amount and basis of the damage in Section 7 and attach supporting documents.) | Art. 11/1-(ğ) |
You may withdraw your explicit consent at any time without giving a reason. Withdrawal takes effect prospectively and does not affect the lawfulness of processing carried out on the basis of consent before its withdrawal. You may withdraw your explicit consent within this application by selecting the relevant option below or by contacting support@treatx.health. Where the Platform provides a direct withdrawal mechanism for the relevant consent, you may also use that mechanism. You may review and change your cookie preferences at any time through the "Cookie Settings / Çerez Ayarları" link in the footer of every page.
Selection | Consent Withdrawn | Consequence |
☐ | Explicit consent to the processing of my health data on the Platform and its transfer to my selected Service Provider | Processing on the Platform will cease immediately and the Platform copy will be destroyed; the minimum evidence record showing that consent had been given will be retained. If you have an active quotation or booking, the process may no longer be able to continue through the Platform; in such case, we will contact you. Any statutory record-retention obligations of the Service Provider under healthcare legislation remain unaffected. |
☐ | Explicit consent to publication of my before/after (B/A) images — Channel / images: .................... | The images will be removed from publication on the Platform immediately and the Platform copies will be destroyed. |
☐ | Explicit consent to marketing communications and commercial electronic message approval: ☐ E-mail ☐ SMS ☐ [Push notification] | Processing for marketing purposes will cease and the opt-out will be reflected in İYS. You may also opt out through the unsubscribe mechanism in each communication or via iys.org.tr. Permission and opt-out records are retained for evidentiary purposes. |
☐ | Explicit consent to retention in the candidate pool | Your data will be removed from the candidate pool and destroyed. |
☐ | Explicit consent to transfer abroad (occasional transfer) | No new transfer based on that consent will be made. |
Please describe your request together with the relevant data, transaction and period (e.g. booking number, date range). For rectification requests, state the correct information; for objections, state the result to which you object; and for compensation requests, state the nature, amount and basis of the damage.
Description of Request | |
Documents Attached (if any) | |
As a rule, a copy of an identity document is not requested. If your identity cannot be verified through the application channel, additional information or documentation may be requested. If you need to submit a document, redact information unrelated to the application (for example, religion or blood group fields on older Turkish identity cards). If your request or attachments contain health data, do not send them by unencrypted e-mail; please use the in-Platform application channel or KEP.
If the application is submitted on behalf of the Data Subject, the fields below must be completed and proof of authority must be attached. Due to the confidentiality of health data, applications made by relatives of a Service Recipient on behalf of that person cannot be resolved without the Data Subject’s authorisation; in such cases, the applicant will be informed that proof of authority must be provided.
Field | Information |
Full name of the person submitting the application | |
Turkish ID / Passport Number | |
Contact details (address, e-mail, telephone) | |
Capacity and proof of authority attached | ☐ Attorney — notarised power of attorney (if issued abroad, apostilled or consularly certified) |
Please indicate how you would like our response to be delivered:
☐ Through my Platform account
☐ To my e-mail address registered in the system
☐ To my KEP address — KEP address: ....................................................
☐ By post to the address stated in Section 3
☐ I wish to collect it in person from the Company address (identity document required; a power of attorney is required for collection by proxy)
Responses containing health data will not be sent through unsecured channels such as unencrypted e-mail. In such cases, the response will be delivered through your Platform account, to your KEP address, or by an encrypted method. If no method is selected, the response will be provided through the channel used to submit the application.
Time and fee: Your application will be concluded free of charge as soon as possible and in any event within 30 days, depending on the nature of the request (KVKK Article 13). If the transaction requires an additional cost, the tariff under the Communiqué will apply: no fee is charged for a written response of up to 10 pages; a processing fee of TRY 1 may be charged for each page exceeding 10 pages; where the response is provided on a recording medium such as a CD or USB drive, the fee may not exceed the cost of that medium. If the application arises from an error attributable to the Company, any fee collected will be refunded.
Identity verification and clarification: The Company may request information to determine whether the applicant is the owner of the personal data concerned and may ask questions to clarify matters raised in the application.
Outcome: The application will be accepted or rejected with reasons stated; the response will be communicated in writing or electronically. If the request is accepted, the necessary action will be taken without delay.
Statutory retention obligations: Records that are legally required to be retained despite a deletion request (for example, electronic commerce, tax and contractual records) will be retained only for the relevant statutory period and with restricted access, and will be destroyed at the end of that period. You will be informed of this with reasons (Personal Data Retention and Destruction Policy).
Exceptions: In the circumstances listed in Article 28/2 of the KVKK (prevention of crime or criminal investigation; data made public by the Data Subject; supervisory, regulatory or disciplinary duties of authorised public institutions; protection of the State’s economic and financial interests), the rights under Article 11 do not apply, except for the right to claim compensation for damage. Where applicable, the reason will be communicated to you.
Right to complain: If your application is rejected, you find the response insufficient, or no response is provided within the prescribed period, you may lodge a complaint with the Personal Data Protection Board within 30 days from the date you learn of the response and, in any event, within 60 days from the application date (KVKK Article 14).
Identity, contact and request information, and health data where included in your request, that you provide in this form and its attachments are collected and processed by TreatX as data controller, through the application channel selected by you and in electronic or physical form, for the purposes of verifying your identity, evaluating and responding to your application, taking the action required by your request, and establishing evidence in proceedings before the Personal Data Protection Board and in disputes. The legal grounds are Article 5/2(ç) of the KVKK (compliance with the data controller’s legal obligation — KVKK Article 13 and the Communiqué) and Article 5/2(e) (establishment, exercise or protection of a right), and, in relation to health data, Article 6/3(b) and (d). To the extent necessary for the request, data may be transferred to the relevant Service Provider (with your knowledge), to third parties to whom your data have been transferred for notifications under Article 11/1-(f), to legal advisers, and, upon request, to the Personal Data Protection Board and judicial authorities. Application and response records are retained for 10 years from completion of the application and are destroyed thereafter in accordance with the Personal Data Retention and Destruction Policy. Further information is available in the privacy notices published on the Platform.
I request that my application to TreatX in accordance with the requests stated above be evaluated pursuant to Article 13 of the KVKK and that the outcome be communicated to me by the method I have selected. I declare that the information I have provided in this form is accurate and up to date and, if I am applying on behalf of another person, that I am duly authorised to do so. I understand that additional information may be requested to verify my identity or clarify my request, and that my application may not be concluded if false or incomplete information is provided.
Field | Information |
Applicant (or authorised representative) — full name | |
Application date | |
Signature (for written applications) |
Field | Company Record |
Application number | |
Date and channel through which the application reached / was served on the Company | |
Identity verification method | |
Last day of the 30-day period | |
Responsible unit / person | |
Forwarding to Service Provider (if applicable): date and Service Provider | |
Outcome | ☐ Accepted ☐ Partially accepted ☐ Rejected — Response date: .................... |