CCPA Do not sell personal information

"*" indicates required fields

Thank you for contacting us. While we do not sell personal information to 3rd parties, we nonetheless respect consumer privacy rights. In accordance with the California Consumer Privacy Act, Passport Health has provided this form for California residents to submit a request to access personal information in compliance with the CCPA. If you prefer to submit your request via phone, please contact us at (844) 224-3177 and follow the prompts.

Name*

Phone Number*

Email*

Last Date of Interaction with Company*

Please check the box to indicate your request:*

Request to access the personal information held by the Company

Request to restrict processing of information

Request erasure of data held by Company

Comments

We will confirm receipt of your request within 10 days, and your request will be fully addressed within 45 days. If we cannot complete your request within that time frame, we will notify you, and the response shall not take longer than an additional 45 days.

This field is for validation purposes and should be left unchanged.

Do Not Sell My Personal Information (CCPA Opt-Out)

For flu clinic resources or materials