Please indicate which request(s) you are making Right to Know: Categories of personal informationRight to Know: Categories of sources from which personal information is collectedRight to Know: Categories of personal information that we sold or disclosed for a business purposeRight to Know: Categories of third parties to whom the personal information was sold or disclosed for a business purposeRight to Know: The business or commercial purpose for collecting or selling personal informationRequest to Access Specific Pieces of Personal InformationRequest to Delete Personal Information: to have the personal information you have about me deletedRequest to Opt-Out of Sale of Personal Information

First Name

Last Name

Address (street/city or town/state/zip)

Email

Phone Number

Please provide any information that might be helpful in reviewing your request as to how you have interacted with us

Are you a representative/employee of a current or prior Vizient customer? YesNo

Are you a representative/employee of a current or prior vendor to Vizient or to one of its customers? YesNo

Are you a health care provider? YesNo

I am an authorized agent for the consumer

I agree

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