California Consumer Request Form

Instructions: California residents may use this form to submit requests under the California Consumer Privacy Act (CCPA) regarding personal information collected by EyeMed that is subject to the CCPA.  

Much of the personal information that EyeMed collects is exempt from the CCPA, including information that is protected under other federal and/or state health privacy laws.  (For example, if you are a member of EyeMed, personal information about you is governed by HIPAA and is exempt from the CCPA. Please see our HIPAA Notice of Privacy Practices for information about how we handle your personal information subject to HIPAA.)

For certain requests, we may ask for additional information or documents to verify the identity of the consumer who is the subject of the request.  The information provided through this form will be used only to respond to your request, including verifying identity, identifying personal information responsive to your request, and keeping records of your request.