Profile Picture
Dr. Andan Clinic Online
×
Merhaba,
Size nasıl yardımcı olabiliriz?
Hello,
How can we help you?

Dr. Andan Clinic

Заявление о явном согласии

CONSENT FOR PHOTO AND VIDEO SHARING

Due to the nature of aesthetic and plastic surgery procedures; I hereby consent to the use of my photographs and videos taken before, during, and after the medical procedure:

[ ] WITH MY IDENTITY CONCEALED (In a way that my face cannot be recognized, e.g., by blurring/banding the eyes): I consent to their sharing on the clinic’s social media accounts (Instagram, Facebook, YouTube, etc.), website, and in scientific presentations for educational and promotional purposes.

[ ] WITH MY IDENTITY REVEALED (In a way that my face can be recognized): I consent to their sharing on the clinic’s social media accounts, website, and promotional materials.

[ ] I DO NOT CONSENT TO THE SHARING OF MY VISUAL RECORDS. (They will only be kept in the medical archive).

COMMERCIAL ELECTRONIC COMMUNICATION CONSENT

[ ] I CONSENT: I allow SMS, E-mail, and Calls to be made to me regarding campaigns, discounts, new service promotions, special occasion greetings, and informative content.

[ ] I DO NOT CONSENT.

INTERNATIONAL DATA TRANSFER CONSENT (Optional – For cloud systems, etc.)

[ ] I CONSENT: I consent to the transfer of my personal data abroad due to the fact that the servers of the e-mail providers or cloud-based storage services used are located abroad.

Patient Name and Surname: ……………………………………………………

T.R. Identity Number: ……………………………………………………

Date: ….. / ….. / 20…..

Signature: ……………………………………………………