Explicit Consent Statement for Online Preliminary Assessment and International Data Transfers
Effective date: 18 August 2026
Version: 1.0
1. Data Controller
Legal name: DRSMİLE AĞIZ VE DİŞ SAĞLIĞI HİZMETLERİ LİMİTED ŞİRKETİ
Trading name: Dr Smile Antalya
Address: Meydankavağı Mah., Avni Tolunay Cad., C Blok No:53, Muratpaşa, Antalya, Türkiye
MERSIS No.: 0313135043400001
Website: https://www.drsmileantalya.com
Email: info@drsmileantalya.com
KEP: drsmile@hs01.kep.tr
Telephone/WhatsApp: +90 545 213 09 09
2. Information Provided Before Consent
Before making any choice below, I confirm that I have been given access to the Website Privacy and Personal Data Processing Notice.
I have been informed about:
- The identity and contact details of the data controller;
- The categories of personal data involved;
- The purposes and legal grounds of processing;
- Possible recipients;
- International transfers;
- Retention criteria;
- Security measures;
- My legal rights;
- The methods for contacting Dr Smile Antalya;
- The method for withdrawing consent.
The consent choices below are separate from the Privacy Notice and from each other.
They must not be pre-selected.
Refusing an optional consent does not prevent me from submitting a general enquiry that does not require the relevant health data, upload or international digital channel.
3. Choice A – Health Data for an Online Preliminary Assessment
This choice applies when I voluntarily provide:
- Dental photographs;
- X-rays;
- Oral or dental health information;
- Medical history;
- Medication information;
- Allergy information;
- Previous treatment information;
- Other health information relevant to my enquiry.
☐ I give my explicit consent to Dr Smile Antalya processing the health data and files that I voluntarily submit for the purposes of reviewing my enquiry, enabling an authorised dental professional to conduct an online preliminary assessment, discussing possible treatment options, planning a consultation and contacting me about my request.
I understand that:
- An online preliminary assessment is not a final diagnosis;
- It does not confirm my suitability for treatment;
- It does not constitute a final treatment plan;
- It does not guarantee treatment duration or results;
- A clinical examination and diagnostic imaging may be required.
If I do not give this consent, I must still be allowed to submit a general enquiry without health information or uploaded files.
Where another lawful processing condition under Article 6 of the KVKK applies to a specific healthcare activity, the Clinic may process the relevant health data on that legal ground after providing the required information.
4. Choice B – International Transfer Through Selected Digital Services
This choice applies where Dr Smile Antalya relies on explicit consent for an international transfer connected with a digital service or communication channel selected by me.
Depending on the service I choose, personal data may be transmitted to or accessed through service infrastructure operated outside Türkiye by providers such as:
- Meta/WhatsApp;
- Google;
- Make.com;
- Telegram.
The exact active provider and purpose must be identified in the Privacy Notice, Cookie Settings or form interface before submission.
☐ I give my explicit consent to the transfer abroad of the personal data contained in my selected digital communication and, where I include them, my health data and uploaded files, solely to enable the communication, file delivery, preliminary assessment and response I requested through the identified provider or providers.
I understand that I may ask Dr Smile Antalya whether an alternative contact method is available that does not rely on this consent.
This consent must not be used where Dr Smile Antalya relies on another lawful international-transfer mechanism under Article 9 of the KVKK.
Where another transfer mechanism applies, that mechanism and the relevant recipient categories must be accurately explained in the Privacy Notice.
5. Withdrawal of Consent
I may withdraw either consent choice at any time by:
- Emailing info@drsmileantalya.com;
- Sending a KEP message to drsmile@hs01.kep.tr;
- Submitting a written request to Meydankavağı Mah., Avni Tolunay Cad., C Blok No:53, Muratpaşa, Antalya, Türkiye.
Withdrawal does not affect processing carried out lawfully before withdrawal.
Withdrawal may limit Dr Smile Antalya’s ability to continue an online preliminary assessment where the assessment depends on the withdrawn health data or digital channel.
6. Form Checkboxes
Use the following as two separate, unticked form fields.
Health-data checkbox
☐ I explicitly consent to the processing of the health data and files I voluntarily provide for my online preliminary assessment.
This checkbox should become mandatory only when the user provides health information or uploads a photograph, X-ray or medical document.
International-transfer checkbox
☐ I explicitly consent to the international transfer of the personal data contained in my selected communication through the identified provider or providers, as explained above.
This checkbox should become mandatory only when explicit consent is the legal basis relied upon for the selected international communication or transfer route.
7. Consent Record
For electronic consent, Dr Smile Antalya should securely record:
- The selected consent statement;
- The full wording and version presented;
- The date and time;
- The form or page used;
- The language;
- The provider or transfer route;
- The user’s selection;
- The withdrawal date and history, where applicable.
Only the information necessary to demonstrate the consent choice should be retained.
8. Prohibition on Combined Consent
Do not use one combined checkbox stating that the user:
- Accepts the Privacy Notice;
- Consents to health-data processing;
- Consents to international transfers;
- Accepts cookies;
- Accepts marketing communications.
Each consent-dependent activity must have its own clear, specific and unticked control.
The Privacy Notice must be provided as information and must not be presented as an agreement requiring approval.