Nevada Health Privacy Rights Request Form

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If you are a Nevada resident, subject to limitations under applicable law, you have certain rights with respect to your personal health information.

For more information about our processing of personal information, visit our U.S. Privacy Notice, which includes our Nevada Health Privacy Notice.

Nevada Residents: Please complete the form below.

First name:

Last name:

Email:

Phone:

Address:

City:

ZIP:

State:

As a Nevada resident, subject to limitations under applicable law, you have certain rights with respect to your personal health information.

To exercise your rights, check below:

Access my personal health information

Correct my personal health information

Delete my personal health information

Appeal a decision

We do not sell your personal health data in exchange for monetary compensation. We may share your personal health data to provide a product or service that you have requested, in accordance with our Nevada Health Privacy Notice. Please visit our U.S. Privacy Notice, which includes our Nevada Health Privacy Notice, for more information about your privacy rights and our privacy practices.

Nevada Health Privacy Rights Request Form

Thank you for your request.