Escalent | Limit the Use of My Sensitive Personal Information

If you are a research respondent of Escalent we may collect sensitive personal information from you under certain circumstances.

As a California consumer, or if you are located in another state which grants you a similar right, you have the right to limit the processing of your sensitive personal information.

Please note that if you exercise this right, because of the nature of our research business it may not be possible for you to continue serving as a research respondent.

You may exercise this right by filling out the webform below, or by contacting us at (877) 631-3505. If you choose to exercise your right (either directly or via an authorized agent), we may request certain personal information such as name, email, or phone number in order to verify that you (and, as applicable, your agent) do in fact authorize the request.

For more information about how we collect, use, and store your personal information, and for more information about your privacy rights, please see our Privacy Policy.

Contact Information
First Name*
Last Name*
Email Address*
Phone Number*
California Residency*
- Under penalty of perjury, I declare that I am a resident of the state of California.
Declaration*
- Under penalty of perjury, I declare that the above information is true, correct and that I am the person or authorized agent of the person whose name appears above.
Detail of Request
Please enter a brief description of your request in the box below.*
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Limit the Use of My Sensitive Personal Information

Contact Information

Detail of Request