Data Subject Access Request (DSAR) Form

Use this form to request access to, correction, deletion, or export of your personal information, or to withdraw your consent. We will respond to your request within 30 days, as required by data protection laws such as GDPR and CCPA.

Full Name:


Email Address:


Type of Request:
-- Please Select -- Access My Personal Data Request Correction of Personal Data Request Deletion of Personal Data Request Export of Personal Data Withdraw Consent

Additional Details (optional):

Note: We may request additional verification to protect your data. If you have any questions, please email us at operationsteam@clinicianscheck.com.