Data Subject Application Form
Medex Sağlık ve Teknoloji Çözümleri Yatırım A.Ş.
Address: Yaşamkent 3066 Sk. No: 10 Çankaya/Ankara
This form is provided to allow you to exercise your rights under the Turkish Personal Data Protection Law No. 6698 (KVKK). You may use this form to submit requests regarding your personal data.
Applicant Information
| Category | Details |
|---|---|
| Full Name: | |
| National ID Number: | |
| Contact Information: | - Phone: |
| - Email: | |
| Address: |
Relationship with Medex-CRO
| Category | Details |
|---|---|
| Your Relationship: | ☐ Employee ☐ Former Employee ☐ Candidate ☐ Third-Party Representative ☐ Other: ____________ |
| Details of Relationship: | (e.g., position, dates of employment, or other relevant details) |
Request Details
| Request Type | Select |
|---|---|
| 1. Access to my personal data | ☐ |
| 2. Request correction of inaccurate data | ☐ |
| 3. Request deletion or anonymization of data | ☐ |
| 4. Object to processing under certain conditions | ☐ |
| 5. Request data portability | ☐ |
| 6. Other (please specify): | ☐ |
Additional Information
If applicable, please provide additional details regarding your request to help us process it efficiently (e.g., data category, timeframe, or specific processing activity):
Proof of Identity
Please attach a copy of your ID (e.g., passport, national ID) to verify your identity.
Response Delivery
| Preferred Method of Response | Select |
|---|---|
| ☐ Physical Mail |
Applicant Declaration
By signing below, I confirm that the information provided in this form is accurate and that I am the individual or authorized representative making this request.
Signature: ____________________________
Date: ____________________________
Submission Details
Please send this completed form along with a copy of your ID via:
- Email: kvkk@medex-cro.com
- Mail: Yaşamkent 3066 Sk. No: 10 Çankaya/Ankara
We will respond to your request within 30 days of receipt, in accordance with KVKK.