Explicit Consent Text

This Explicit Consent Text is provided to obtain consent where the processing of personal data, including special category health data, requires explicit consent under the applicable legislation.

I acknowledge that I have read and understood the Personal Data Protection Clarification Text provided by Özant Dental Clinic.

I consent to the processing of my personal data and, where necessary, my special category personal data including health data, for the purposes of providing dental examination, diagnosis, treatment, follow-up, appointment management, communication, laboratory/imaging/appliance production, archiving and fulfillment of legal obligations.

I also consent to the transfer of my personal data, limited to the relevant purposes and in accordance with the law, to authorized public institutions, healthcare authorities, laboratories, imaging centers, dental appliance/aligner manufacturers, suppliers, IT service providers, consultants and other necessary third parties.

I hereby declare that I have read and understood the clarification text and give my explicit consent for the processing described above.

[   ] I consent      [   ] I do not consent

Name - Surname:

Date:

Signature: