Please indicate which request(s) you are making Request to Know and Access: Categories of personal information (“PI”) collected; Specific PI collected; Categories of sources; Business or commercial purpose for collecting, sharing, or selling PI; Categories of third parties to whom PI is disclosedRequest to Know What Personal Information is Sold or Shared and to WhomRequest to Delete Personal Information: to have the personal information we have about you deletedRequest to Correct Inaccurate Personal InformationRequest to Opt-Out of Sale or Sharing of Personal InformationRequest to Limit the Use and Disclosure of Sensitive 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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