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Privacy Rights Request Form

If you are a resident of California, Colorado, Connecticut, or Virginia, to make a request to exercise your privacy rights, please complete and submit this form.

Please Note: Data privacy laws include exemptions that may apply to our collection and processing of your personal information or personal data (together, “Personal Information”). Therefore, the ability to exercise the rights set out herein may not apply to you or to all of your Personal Information. Please note that your request is subject to verification.

For more information:

If you are a California resident, please read our California Notice at Collection and Privacy Notice.
If you are a resident of Colorado, Connecticut, Utah, or Virginia, please read our U.S. State Privacy Supplement.

First & Last Name:

State of Residence:

Email Address:

Relationship Type (check all that apply)

Premom app user
Website visitor
E-Commerce Customer (purchaser of Easy@Home products or services)
Current or former Easy Healthcare job applicant
Representative of Easy Healthcare vendor
Authorized Agent
Other

Type of Request (check all that apply):

Confirm Processing of Personal Information
Know Categories of Personal Information Being Processed
Access and Obtain Personal Information
Correct Inaccurate Personal Information
Delete Personal Information

Privacy Rights Request Form

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