California resident personal information request

The protection of your personal data is important to SomnoMed, and we are committed to ensuring your privacy rights are respected. The California Consumer Privacy Act of 2018 (“CCPA”) permits residents of the State of California (“California Consumers”) to make certain requests about Personal Information. As such, if you are a Californian resident, you have the right to know what personal information is collected or request that the information be deleted.

To assist us with your request, please fill in the form below. If you are completing this request form on behalf of someone else, please fill in the Californian person’s details as well as your information.

For more information, please view our privacy policy.

California resident personal information request form

"*" indicates required fields

Requestor Details*
Please fill in the details as the requester:
Select the type of request that you are submitting as, or on behalf of, a California resident or household (check all that apply):
Select the type of request that you are submitting as, or on behalf of, a California resident :
Please choose your California resident status (check one):*
Please choose your California resident status (check one)*:
The Californian Resident Name
If you are completing this form on behalf of another Californian resident, please fill in the Californian resident's details that you are requesting information or deletion of data. Otherwise, leave blank:
Relationship to Californian resident
If you are completing this form on behalf of a Californian resident, please confirm your authority to request information or deletion of it:
By signing the below, I hereby acknowledge that the information provided is complete, accurate and up to date and that I am the Californian resident or have been authorized to act on his or her behalf. I understand it may be necessary for SomnoMed to verify my identity for this request and as such additional information may be requested.
Clear Signature
This field is for validation purposes and should be left unchanged.