Data Subject Access Request Form

Please fill in the information below. Our data protection officer will be notified of your request and will respond promptly.

Name

First Name

Last Name

What email do you use to access the Birth Model platform?

You are submitting this request as

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.

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 Birth Model.

I understand that I will be required to validate my request by email, and I may be contacted in order to complete the request.