Consumer Data Subject Request

Under the California Consumer Privacy Act (CCPA), California residents are entitled to make certain requests regarding the personal information that Rotech Healthcare Inc. holds, shares, or uses about them.

Additionally, while Rotech does not sell personal information, under Nevada SB 220 you are entitled to make a request not to sell your personally identifiable information. Please review Rotech Healthcare’s Privacy Policy for further information on what information we collect and why we collect it.

If you are a California or Nevada resident and would like to submit a request under CCPA or SB 220 respectively, please complete the form below. We ask that you provide this information so that we can verify your identity and respond to your request.

Residency:*
- I am a California Resident
- I am a Nevada Resident
Consumer Information
Full Name:*
Any other names you may be known by:
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Email
Phone
Global Patient ID Number
Type of Request
I request the following*
- ACCESS to the specific personal information Rotech Healthcare Inc. has collected about me
- IDENTITY of the categories of data for which Rotech Healthcare Inc. has collected my personal information
- DELETION of my personal information (you will be contacted separately to confirm you want your information deleted.)
Verification*
- Under penalty of perjury, I declare the above information is true, correct, and that I am the person or the parent or guardian of the person whose name appears above.
Comments
This field is for validation purposes and should be left unchanged.

EMAIL PRIVACY WARNING: Communications via email over the internet in general, and via unencrypted email in particular, are not secure and there is a possibility that information included in an email can be misdirected or intercepted and read by other parties besides the person to whom it is addressed. You should not use email for emergencies or other time-sensitive matters. By submitting information through our contact form, you are consenting to receive communication from Rotech Healthcare Inc. (or any of its subsidiaries) via unencrypted email.

Consumer Data Subject Request

Consumer Data Subject Request

Consumer Information

Type of Request

Products & Services

For Patients

For Practitioners