{"id":26652,"date":"2024-05-23T05:35:01","date_gmt":"2024-05-23T10:35:01","guid":{"rendered":"https:\/\/timelycare.com\/?page_id=26652"},"modified":"2024-05-23T05:42:50","modified_gmt":"2024-05-23T10:42:50","slug":"privacy-rights-request-form","status":"publish","type":"page","link":"https:\/\/timelycare.com\/privacy-rights-request-form\/","title":{"rendered":"Privacy Rights Request Form (05 – 2024)"},"content":{"rendered":"\t\t
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Privacy Rights Request Form<\/h1>\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t
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\n\t\t\t\t\t\t\t\t\t\t\t\t\t\"TimelyMD\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t
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At\u00a0TimelyCare<\/b><\/span>, your privacy is important to us. Depending on where you live or your location, you may be able to exercise certain data rights under applicable privacy laws.<\/p>

For more information about how personal and household information is collected and used, please review our Privacy Notice<\/a>.<\/p>

If you are an authorized person and want to make a privacy request for yourself or on behalf of someone else, please complete the following form. The information provided will be used to verify your right to request this information and to respond to your request.<\/p>

In certain circumstances, we may require additional information if we are unable to verify your request based on the information provided. The personal information submitted in connection with your request will be used for the purpose of processing your request.<\/p>

If you have any questions, call us at\u00a01-833-484-6359<\/a> Monday \u2014 Friday, 8:00 am – 6:00 pm CST.<\/p>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t

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    <\/ul><\/div>\n
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    \n<\/fieldset>\n

    Consumer Information<\/u><\/strong>\n<\/p>\n

    Name of Consumer (First, Middle, Last)*
    \n<\/span>\n<\/p>\n

    Prior Name (if Applicable)
    \n<\/span>\n<\/p>\n

    Address*
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    Address Line 2
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    City*
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    State*
    \n<\/span>\n<\/p>\n

    ZIP Code*
    \n<\/span>\n<\/p>\n

    Email address
    \n<\/span>\n<\/p>\n

    Phone Number 1*
    \n<\/span>\n<\/p>\n

    Phone Number 2
    \n<\/span>\n<\/p>\n

    Requester Information<\/u><\/strong>\n<\/p>\n

    If you are both the consumer and requester, please skip to the next section.\n<\/p>\n

    Name of Requester (First, Middle, Last)
    \n<\/span>\n<\/p>\n

    Relationship to Consumer
    \n<\/span>\n<\/p>\n

    Address
    \n<\/span>\n<\/p>\n

    Address Line 2
    \n<\/span>\n<\/p>\n

    City
    \n<\/span>\n<\/p>\n

    State
    \n<\/span>\n<\/p>\n

    ZIP Code
    \n<\/span>\n<\/p>\n

    Email address
    \n<\/span>\n<\/p>\n

    Phone Number 1
    \n<\/span>\n<\/p>\n

    Phone Number 2
    \n<\/span>\n<\/p>\n

    If you are requesting information as an authorized agent, additional documentation will be required, and we will contact you about your request.\n<\/p>\n

    Consumer Type<\/u><\/strong>\n<\/p>\n

    To help us respond to your request, please indicate your consumer type.*
    \n<\/span>\n<\/p>\n

    Request Type<\/u><\/strong>\n<\/p>\n

    Please indicate the type of request you would like to make.*
    \n<\/span>\n<\/p>\n

    Preferred method for responding to your request.*
    \n<\/span><\/span><\/span> By selecting the submit button below, I declare under penalty of perjury that I am the consumer whose Personal Information is the subject of this request or an authorized requester on behalf of such consumer.\n<\/p>\n

    \n<\/div>\n\n

    \n<\/p>

    <\/div>\n<\/form>\n<\/div>\n<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"

    Privacy Rights Request Form At\u00a0TimelyCare, your privacy is important to us. Depending on where you live or your location, you may be able to exercise certain data rights under applicable privacy laws. For more information about how personal and household information is collected and used, please review our Privacy Notice. If you are an authorized […]<\/p>\n","protected":false},"author":39,"featured_media":0,"parent":0,"menu_order":172,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_acf_changed":false,"content-type":"","site-sidebar-layout":"no-sidebar","site-content-layout":"page-builder","ast-site-content-layout":"full-width-container","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"disabled","ast-breadcrumbs-content":"","ast-featured-img":"disabled","footer-sml-layout":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"set","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"var(--ast-global-color-4)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"ast-content-background-meta":{"desktop":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"footnotes":""},"categories":[125],"class_list":["post-26652","page","type-page","status-publish","hentry","category-core"],"acf":[],"yoast_head":"\nPrivacy Rights Request Form (05 - 2024) - TimelyCare<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/timelycare.com\/privacy-rights-request-form\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Privacy Rights Request Form (05 - 2024) - TimelyCare\" \/>\n<meta property=\"og:description\" content=\"Privacy Rights Request Form At\u00a0TimelyCare, your privacy is important to us. 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