Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.What is your name? *What is the email address associated with your Patch account? *I am submitting this information on behalf of: *The person, or the parent / guardian of the person, whose name appears above.An agent authorized by the consumer to make this request on their behalf.Under the rights of which law are you making this request? *CCPAGDPRWhat is the reason of your request? *Get a copy of my personal informationEdit or correct my personal informationRestrict the processing of my personal informationDelete all my personal informationI confirm the following: *Under penalty of perjury, I declare all the above information to be true and accurate.I am the consumer of the Patch Website or the agent authorized by the consumer to make this request on their behalf.I understand that the deletion or restriction of my personal information is irreversible and may result in the termination of services with the Patch Website.I understand that I will be required to validate my request by email and I may be contacted in order to complete the request.Submit
