Data Subject Request Web Form

For requests under US state comprehensive privacy laws

I am making a request on behalf of:(Required)

myself

another individual*

First Name(Required)

Last Name(Required)

Email(Required)

Phone(Required)

Physical Address(Required)

I am a resident of the state of:

Consumer Type:

Do you have an online account with us?

Yes

Select request type:

*Note that if you are making this request as an authorized agent on behalf of another, please provide your information in the “Additional information from registered agents” section below.

To exercise the right to opt out of “sharing” (for targeted advertising) or sale of personal information, please see our cookie preference management tool.

Additional information from authorized agents:

If you make a request on behalf of another individual, you will act as an authorized agent. We will require documentation of your authority to act as an authorized agent, such as a written authorization, and such documentation should be attached to this form.

Authorized Agent First Name

Authorized Agent Last Name

Authorized Agent Email

Authorized Agent Phone

Authorized Agent Physical Address

By submitting this request, you certify the information provided above is accurate, complete, and up-to-date. Please note that, in some circumstances, we may contact you to request additional information to verify your identity.

For requests in relation to consumer health data under the laws of Nevada and Washington