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EXPRESS CONSENT FORM ON THE PROCESSING OF PERSONAL DATA ​ ​

The personal, which is detailed in the Clarification / Informing reflection on the Processing of Personal Data by Yücelen Hospitals, is required for the performance of the contract, stipulated in the law as required, mandatory for us to fulfill our legal provisions and protection of health, preventive medicine, medical diagnosis, treatment and care procedures, health and excluding final and transportation cases to the extent appropriate for the planning and management of financing; We request your explicit consent regarding the following details; Collection, Processing and Processing Purposes of Personal Data In order to provide me with high standards of service, by reading the Information / Information about the Processing of Personal Data about my personal data obtained verbally, in writing, visually, or electronically from the Call Center, internet, mobile applications, architectural structures and similar channels, depending on the characteristics of the service provided I informed. The details of the comprehensive general and private personal data obtained, especially the personal health data required for all medical examination, examination, treatment and care counseling in these centers and for this purpose, are listed;

• My identity data such as my name, surname, TR identity number, passport number if I am a Turkish owner, or temporary TR identity number, place and date of birth, marital status, gender information, and a photocopy of the Card or Driver's License I have submitted,

• My contact data such as my address, telephone number, e-mail address,

• My financial data such as my bank account number, IBAN number,

• Health and sexual life data obtained during the execution of medical diagnosis, treatment and care services such as my laboratory and imaging results, test results, examination data, prescription information, which I have submitted in order to be followed in my file,

• Replies and comments I shared with the aim of evaluating your services,

• My closed-circuit camera system video and audio recording taken during my visit to your hospitals,

• Audio call recordings kept if I contacted your Call Center,

• My data on private health insurance and Social Security Institution data for the purpose of financing and planning health services,

• If I use the parking lot and valet service, my license plate efficiency,

• My browsing information, IP address, browser information and medical documents, surveys, form information and location data that I have submitted voluntarily, obtained during the use of your website.

• The information I provided during my job application I have been informed that my personal data listed above and my personal data of special nature can be processed for the following purposes;

• Protection of public health, preventive medicine, medical diagnosis, treatment and care services,

• Sharing requested information with the Ministry of Health and other public institutions and organizations in accordance with the relevant legislation,

• Fulfilling legal and regulatory requirements,

• Financing of my health services, meeting your examination, diagnosis and treatment expenses by the Patient Services, Financial Affairs, Marketing departments, sharing the information requested with private insurance companies within the scope of the plausibility inquiry,

• To be informed about my appointment through your Call Center and Digital Channels,

• Confirmation of my identity by the Patient Services, Health Professionals and Call Center departments,

• Planning and management of the internal functioning of the institution by the Hospital Management,

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• Analysis by the Quality, Patient Experience, Information Systems departments for the purpose of improving health services,

• Training your employees by the Human Resources and Quality departments,

• Monitoring and prevention of abuse and unauthorized transactions by the Audit and Information Systems departments,

• Carrying out risk management and quality improvement activities by the Quality, Patient Experience, Information Systems departments,

• Invoicing for your services by the Patient Services, Financial Affairs, Marketing departments,

• Confirmation of my relationship with the institutions contracted with your hospital by the Patient Services, Financial Affairs, Marketing departments,

• To be able to answer all my questions and complaints regarding the health services given or to be provided to me by the Hospital Management, Patient Experience, Patient Rights, Call Center departments,

• All necessary technical and taking administrative measures,

• Participation in campaigns and providing campaign information by Marketing, Media and Communication, Call Center departments, designing and transmitting special content, tangible and intangible benefits on web and mobile channels,

• Measuring, increasing and researching patient satisfaction by the Hospital Management, Patient Rights, Patient Experience departments,

• In order to carry out education and training activities by the educational institutions with which the institution is in cooperation. I have been informed in detail that my "Personal and Private Data" mentioned above can be kept in physical and electronic archives within the body of Yücelen Hospitals and external service providers with great care and compliance with the provisions of the legislation. Transfer of Personal Data My personal data, Health Services Basic Law No. 3359, Decree Law No. 663 on the Organization and Duties of the Ministry of Health and its Affiliates, Law on the Protection of Personal Data No. 6698, Regulation on Private Hospitals, Regulation on the Processing of Personal Health Data and Protection of Privacy, and regulations of the Ministry of Health and other within the framework of the provisions of the legislation and for the purposes described above;

• With the Ministry of Health, its sub-units and family medicine centers,

• Private insurance companies (health, pension, life insurance, etc.),

• With the Social Security Institution,

• With the General Directorate of Security and other law enforcement agencies,

• With the General Directorate of Population,

• With the Turkish Pharmacists Association,

• With judicial authorities,

• With laboratories, medical centers, ambulances, medical devices and institutions providing health services in the country or abroad that you cooperate with as Yücelen Hospitals for medical diagnosis and treatment, With the legal representatives I have authorized,

• With the third parties you consult, including the lawyers, tax consultants and auditors you work with,

• With regulatory and supervisory institutions and official authorities, 2 / 4

• To systems in the country or abroad and/or to your branches within the group of companies to which your Hospital is affiliated,

• In case my billing will be made to the employer, with my employer for this purpose,

• It can be shared with the suppliers, support service providers, archive service providers and business partners whose services you benefit from or cooperate with as a company (I know that I can get information by applying to our hospital in writing for more detailed information). Method and Legal Reason for Personal Data Collection My personal data, in all kinds of verbal, written, visual or electronic media, to carry out all kinds of work within the legal framework, including the above-mentioned purposes and the field of activity of Yücelen Hospitals, and within this scope, to fulfill the contractual and legal obligations of Yücelen Hospitals fully and properly I was informed that it is being collected and processed for These persons are the legal reason for the collection of my data;

• Law No. 6698 on the Protection of Personal Data,

• Health Services Basic Law No. 3359,

• Decree Law No. 663 on the Organization and Duties of the Ministry of Health and its Affiliates,

• Private Hospitals Regulation,

• Regulation on the Processing of Personal Health Data and Protection of Privacy,

• Regulations of the Ministry of Health and other legislative provisions. In addition, as stated in paragraph 3 of Article 6 of the Law, personal data related to health and sexual life can only be kept confidential for the purposes of protecting public health, performing preventive medicine, medical diagnosis, treatment and care services, planning and managing health services and financing. I know that it can be processed without my explicit consent by persons or authorized institutions and organizations under the obligation. Your Rights Regarding the Protection of Personal Data In accordance with the law and relevant legislation;

• Learning whether my personal data is processed,

• If my personal data has been processed, requesting information about it,

• Accessing and requesting my personal health data,

• To learn the purpose of processing my personal data and whether they are used in accordance with its purpose,

• To know the third parties in the country or abroad to whom my personal data

• Requesting correction of my personal data in case of incomplete or incorrect processing,

• Requesting the deletion or destruction of my personal data,

• Requesting notification of the third parties to whom my personal data has been transferred, regarding the correction of my personal data and/or the deletion or destruction of my personal data in case of incomplete or incorrect processing of my personal data,

• Objecting to the emergence of a result against myself by analyzing my processed data exclusively through automated systems,

• I have been informed that I have the right to demand the compensation of the damage in case I suffer a loss due to the unlawful processing of my personal data. 3 / 4 By filling out the "Application Form Pursuant to the Law on the Protection of Personal Data" on the web address of "www.yucelenhastanesi.com";

• I can deliver to Marmaris Bulvarı Kötekli Mahallesi 65 Sokak 22/C-1 48000 Menteşe/MUĞLA address,

• I can send it through a notar

• I know that I can send it to gursoyturizmsaat@hs02.kep.tr with a secure electronic or mobile signature, via my registered e-mail address or my registered e-mail address in your system. I have read and understood the Clarification/Information on the Processing of Personal Data prepared by Yücelen Hospitals, I have been informed about the purposes of the processing of my personal data, the institution, organization, company and health professionals to which it is transferred, the methods of collection and legal reasons, my rights to the protection of my personal data, data security and my right to apply, which are detailed in the Clarification/Information on the Processing of Personal Data, My Personal and Private Data; The performance of the contract, clearly stipulated in the law, being mandatory for Yücelen Hospitals to fulfill its legal obligations and processing and transferring as necessary for the purposes of protection of public health, preventive medicine, medical diagnosis, treatment and care services, planning and management of health services and financing Except for the storage, processing and transfer of Personal Data, I AGREE WITH MY EXPRESS CONSENT.

*In accordance with the Patient Rights Regulation; 1 copy of the form will be given to you. Notify when the form is not given to you. CONSENT Write “I understood what I read” in your own handwriting: ………………………………………….. Patient Name Surname………………………… ……………………… Signature:………………Date: ……./……./………Time:…..  Patient Relative Name Surname:……………………………… ……….. Signature:………………Date: ……./……./………Time:….. Proximity: ………………………….. Patient Relative Name and Surname: ……………………………………….. Signature:…………Date: ……./……./………Time:….. Degree of Relation: … ……………………….. Reason for Obtaining Consent from Patient's Relatives: • The patient has not reached the age of 19 (Signature is taken from both parents - mother and father. However, if the divorced family is divorced, the signature is taken from the parent who has custody) • Does not have the power to appeal / does not have the ability to make a decision (signature is obtained from his guardian or legal representative) • Unconscious ---------------------------------------------------------------- ---------------------------------------------------------------- --------------------------- TRANSLATOR (If the patient has a Language/Communication Problem) In my opinion, the information I translated was understood by the patient/patient relative. Name and Surname of Translator: ………………………….……. Signature: …………Date: …../……./……… Time:……

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