This form below may be used for access requests, the right to deletion, and data portability. 

What you need to know: 

1. Once we receive your request to access or delete your information, we will send you a receipt confirming your request within ten (10) business days.
2. We will fulfill requests containing sufficient information within 45 days of receipt or if we cannot fulfill the request within 45 days we will notify you that the request may take 90 days to complete.
3. If sufficient information is not provided, Azalea Health may not be able to fulfill requests.
4. Requests may be refused in accordance with applicable privacy law. If we deny a request, we will provide you with an explanation as to why we denied the request.
5. Depending on the nature of your request, Azalea Health will need to validate your identity in order to complete such request.
6. For customers that maintain an online account with us, you may verify your identity by submitting this request through your online account. Re-authentication may be required before we complete requests to disclose or delete your personal information.
7. For authorized agents making a request on behalf of another individual, we may require that the individual whose information is being requested first provide the authorized agent with written permission to do so, or we will require that the individual verify their own identify directly with Azalea Health.
8. Azalea Health will inform third parties that your personal information has been updated, corrected or erased as necessary.
9. Data Subject Access Request Forms may be mailed to Azalea Health, 5871 Glenridge Drive NE Suite 480, Atlanta, GA 30328 or requested via phone at (877) 777-7686.
10. Please do not list sensitive personal information in the space available.

Please complete the form below to initiate processing of your request.