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Carerevenue Opt Out Form

Good Methods Global Inc. dba CareRevenue Sale of Personal Information Opt-Out Request Form

Each California resident (“Resident”) has the right to opt-out of the sale of their personal information by Good Methods Global Inc. (“carerevenue”).

In order for us to respond to your request to opt-out of the sale of your personal information, we ask that you submit your request using the form below.

We will complete your request to opt-out within 15 days of carerevenue’s receipt of a fully completed form and, if you are an Authorized Agent, proof of your legal authority to opt-out. You do not have to use this form, but using this form should make it easier for you to make sure you have provided us with all relevant information and for us to process your request. You may also submit your opt-out request via email at [email protected].

For more information regarding carerevenue’s privacy practices please review our Privacy Policy available at: https://carerevenue.com/privacy-policy/

1. California Resident’s Name and Contact Information

Please provide the Resident’s information below. If you are making this opt-out request on the Resident’s behalf, you should provide your name and contact information in Section 3.

We will only use the information you provide on this form to (i) identify you, (ii) respond to your opt-out request if needed, and (iii) keep a record of your opt-out request and our respone

We reserve the right to refuse to act on your opt-out request if we have a good faith, reasonable, and documented belief that such request is fraudulent, and will notify you if that is the case.

We reserve the right to refuse to act on your opt-out request if we have a good faith, reasonable, and documented belief that such request is fraudulent, and will notify you if that is the case.

2. Requests Made by an Authorized Agent on a Resident’s Behalf

Please complete this section of the form with your name and contact details if you are acting as an authorized agent on the Resident’s behalf.

Do you have legal authority to request the Resident's personal information?(Required)

We reserve the right to refuse to act on your opt-out request if we are unable to verify your legal authority to act on the Resident's behalf, and will notify you in the event that we cannot verify your ability to act on the Resident's behalf

Acknowledgment

By selecting “Submit” below, I hereby opt-out of the sale of my personal information by carerevenue, I confirm that the information provided on this form is correct, and that I am the person whose name appears on this form, either as the Resident or the Resident's Authorized Agent. If I am the Resident's Authorized Agent I confirm that I am authorized to act on behalf of the Resident. I understand that carerevenue must, in the case of Authorized Agents, verify my legal authority to act on the Resident's behalf, and may need to request additional verifying information. My request will not be valid until carerevenue receives all the required information to process the request.
Confirm(Required)