Web Intake Form
You can request to Opt-out of Sale of your personal information (PI) to third parties by submitting the form below.
Note: We do not make your personal information available for purchase or share your information in exchange for money.
We may share your PI with vendors who provide services to us, or for online advertising and marketing. Sharing of PI may be considered a “sale” under the CCPA’s broad definition of the word “sale”.
Also, you can Request to Know and Request to Delete the PI that we have about you by submitting the form below.
- Upon receipt of your request we will send a confirmation email to the email address on the form.
- Please log into your account to verify your identity and begin processing your request by entering the REQUEST NUMBER that you will receive in the confirmation email.
- Verification of your identity is essential to protect your information.
- If you do not have an account, or have difficulty logging into your account, our customer service representatives at 1-800-925-0212 can help you with the next steps in verifying your identity and processing your request.
- AUTHORIZED AGENTS of California residents may submit a request by calling 1-800-925-0212 or emailing us at email@example.com. Please provide a) written proof of authorization to act as an agent and b) identity details regarding the individual whose information is requested.
We will only use the information submitted in the form to contact you and process your request.