Contact 1 — Swell Health

Data Subject Request Form

Please use this form to initiate the processing of your personal data request.

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Review our privacy policy to see what data is retained and what happens when you delete your account.

I would like to request the following....

Access or transmit my personal data

Object to or restruct processing my personal data

Correct or update my personal data

Erase my account or personal data

Name

First Name

Last Name

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Comments

I confirm that:

Under penalty of perjury, I declare the above information is true, correct and that I am the person, or the parent, guardian or authorized agent of the person, whose name appears above

A request to delete or restrict my personal information is irreversible.

I understand that I will be required to validate my request by email and I may be contacted to complete this request.

I understand and agree that this request will be processed in accordance with applicable law(s), and that I may not receive a response if not required by law.