Privacy Policy Request

I am a California resident: Yes No

Member First Name:
Member Last Name:
Street Address 1:
Address Line 2:
City:
State:
Zip:
Email:
Phone:

Request Type:
Request Access Please send me a copy of the information California Family Health, LLC has collected about me in the last twelve months.
Request to Know
  • Categories of personal information collected about me in the last twelve months.
  • Categories of sources from which the personal information about me was collected.
  • Business purpose for which California Family Health, LLC uses the personal information collected about me
  • Categories of third parties with whom California Family Health, LLC shares or has shared the personal information collected about me in the last twelve months.
Request for Deletion Please delete all personal information that California Family Health, LLC has collected about me.
Are you sure you want us to permanently delete all the personal information that we have collected about you? No Yes
Request to Opt Out I do not want my personal information to be sold. Please cease and refrain from selling my personal information.

Authorized Agent Verification:
This request has been submitted through an agent on my behalf: No
Yes
Agent Full Name:
This agent has been authorized in writing to submit this request on my behalf: No
Yes