Please indicate which request(s) you are making Request to Confirm and AccessRequest to Correct Inaccurate Personal InformationRequest to Delete Personal InformationRequest to Obtain a Copy of Your Personal InformationRequest to Opt-Out of Processing of Your Personal Information for Purposes of Targeted AdvertisingRequest to Opt-Out of Processing of Your Personal Information for Purposes of Sale of Personal InformationRequest to Opt-Out of Processing of Your Personal Information for Purposes of □ Profiling in furtherance of a decision that produces a legal or similarly significant effect

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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