EXPLICIT CONSENT FORM REGARDING THE PROCESSING AND SHARING OF PERSONAL DATA

I have read the “Privacy Notice” presented to me by Op. Dr. Bekir Can Gümüşlü. I have been informed in detail about the purposes for which my personal data and sensitive personal data (health data) will be processed and to whom they may be transferred.

Regarding the following matters, I declare my preferences of my own free will, without being under any pressure:

1. COMMUNICATION CONSENT

I consent to being contacted by Op. Dr. Bekir Can Gümüşlü and his team via SMS, E-mail, or Phone calls regarding appointment reminders, follow-up periods, special day greetings, new procedures, and campaigns. [ ] I Accept [ ] I Do Not Accept

2. PHOTO AND VIDEO SHARING CONSENT

I consent to the sharing of my photographs and video recordings taken before, during, and after aesthetic or medical procedures for the purpose of medical information and promotion on social media accounts (Instagram, Facebook, YouTube, etc.), the website, and scientific publications belonging to Op. Dr. Bekir Can Gümüşlü, either anonymously (using eye bands, etc.) or with my identity visible. [ ] I Accept (My identity may be visible) [ ] I Accept (My identity must be hidden/anonymized) [ ] I Do Not Accept

I am aware that I have the right to withdraw this consent at any time by applying to the clinic.

Full Name:
Date:
Signature: