Data subject access request form

Website Name Email ‍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?I am submitting a request to ___________Know what information is being collected from meHave my information deleted
Opt out of having my data sold to third parties‍Opt in to the sale of my personal dataAccess my personal information
Fix inaccurate informationReceive a copy of my personal information
‍Opt out of having my data shared for cross-context behavioral advertisingLimit the use and disclosure of my sensitive personal informationOther (please specify in the comment box below)Please leave details regarding your action request or question.
I confirm that Under penalty of perjury, I declare all the above information to be true and accurate.I understand that the deletion or restriction of my personal data is irreversible and may result in the termination of services with Psych congress.I understand that I will be required to validate my request by email, and I may be contacted in order to complete the request.

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