data subject rights request form

We collect and use your personal information for our business purposes and to help us deliver the best experience for you. You can use this form to submit a Data Subject Rights Request to us. View our Privacy Policy for more details.

Please note that this form should not be used to submit requests to us relating to protected health information (PHI) we may maintain about you under the Health Insurance Portability and Accountability Act (HIPAA). We will respond to requests we receive via this form solely with respect to information we may maintain about you that is not PHI.

You can also submit a request by calling 1-888-897-5755. Fields marked * are required.

Full name

Email addressUsed to acknowledge and verify your request.

Phone number

State of residence

I am submitting this request as a

What would you like us to do? Select all that apply.

Tell me what personal information you have about me

Delete my personal information

Correct my personal information

Give me a copy of my personal information

Limit the use of my sensitive personal information

Appeal a decision on a previous request

I am an authorized agent submitting this request on behalf of someone else

Details optional

We use the information on this form only to verify your identity and respond to your request. See our Privacy Policy and CA Notice at Collection.

By checking this box and clicking “Submit,” I expressly consent to receive recurring text messages and calls from all.health, including marketing, promotional, informational, and account-related communications, which may be sent using automated technology, an artificial or prerecorded voice, or similar technologies. Consent is not a condition of purchasing any goods or services. Message frequency may vary. Message and data rates may apply. Text STOP to opt out or HELP for assistance.