CCPA/CPRA Consumer Rights Request Form

As detailed in our Privacy Notice for California Residents, California consumers have certain rights regarding their CCPA/CPRA Personal Information ("Personal Information" or "Information" for purposes of this form). This form is for the submission of any consumer requests under the California Consumer Privacy Act to Healow, LLC and its subsidiaries and affiliates (collectively, "Healow"). Please complete the form below and we will respond to your as soon as possible, within the legally mandated timeframe. Such requests may concern:

  • The right to know what CCPA/CPRA Personal Information we collect, including (1) the right to request information regarding the categories of CCPA/CPRA Personal Information we collect along with other information such as the categories of sources from which the information is collected and third parties with whom it is shared and (2) the right to request a copy of the specific pieces of CCPA/CPRA Personal Information we collect (sometimes referred to as the right to access personal information)
  • The right to delete CCPA/CPRA Personal Information that we collect from you, subject to certain exceptions
  • The right to correct inaccurate CCPA/CPRA Personal Information that we maintain about you
  • The right to opt-out of the sale or sharing of CCPA/CPRA Personal Information
  • The right to opt-out of certain uses of Sensitive Personal Information (a subcategory of CCPA/CPRA Personal Information)

California consumers also have the right not to be retaliated or discriminated against for exercising any CCPA/CPRA rights in good faith.

Please note that Healow does not generally sell CCPA/CPRA Personal Information as the term "sell" is traditionally understood (i.e., an exchange of a good or service in return for money). However, to the extent the terms "sale" or "sharing" under the CCPA/CPRA are interpreted to include advertising technology activities such as those disclosed in the Targeted/Advertising Cookies Section and Advertising and Third-Party Data Collection Section of our Privacy Policy, we will comply with applicable law, including by providing the right to opt out of such activities.

Asterisk (*) is required field
Provider     Patient     Healow Employee     Healow Prospective Employee     Business Contact     Other
Know Information (Categories)     Know Information (Specific Pieces)     Delete Information     Correct Inaccurate Information     Limit Use and Disclosure of Sensitive Personal Information     Opt Out of Sale or Sharing    
captcha reloader

By submitting this form, I attest that I am submitting it on behalf of myself, or I am acting as an agent of the individual listed herein.