PRIVACY REQUEST FORM – CA CONSUMER PRIVACY ACT (CCPA)

Please indicate the type of request(s) you would like to submit regarding your personal information:

I would like to know what personal information DaVita currently maintains about me.
Select any categories or specific pieces of information you are requesting DaVita to disclose: 
Information about your right to request

DaVita will confirm receipt of your request within ten (10) days and provide additional information on how your request will be processed. DaVita may ask for additional information to verify your identity or confirm your request, as required by CCPA.

An authorized agent may submit a request on your behalf; however, DaVita reserves the right to request (a) that you verify your identity, and (b) written proof that you have permitted the authorized agent to act on your behalf.

For additional information about DaVita's privacy practices and your rights under CCPA, please review DaVita’s Privacy Policy.