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CCPA Request Webform

California Residents may use this form to exercise their CCPA rights: opt-out of sale; access your information; and delete your information.

If you are a resident of California, and you want to submit a request to Physnet under the California Consumer Privacy Act (CCPA), please fill out the webform below. Required fields are marked with an asterisk.* We will contact you at the email or phone number listed below if we have questions regarding your request.