Error was Detected

Your browser doesn't support JavaScript code, or you have disabled JavaScript.

Enter a search term:
Sign in or Enroll

- Enter City or Zip
  I want to choose my medical group or hospital
- Clear my location

We've expanded your view

You are now viewing all services in the Sutter Health network. You can change your location above to narrow your view to a medical group, hospital, city or zip.

Sutter Health

Find Doctors
Find Locations
Treatments & Services

Locations
Sign in or Enroll

- For Medical Professionals
- Other Business Services

Close Search

Home
Privacy Request

Content

Privacy Request Form: Do Not Sell My Info

Consumer Rights Request

Please use this form to submit your Consumer Rights Request to request that Sutter: provide access to your information; delete your information; not sell your information; and/or provide or withdraw consent to Sutter’s practices regarding personal information as related to someone under the age of 16. You may fill out the form for yourself or someone else (e.g. a dependent or power of attorney).

Your protected health information (PHI) isn’t included in this request. For questions regarding how Sutter Health protects your health information, please view our Notice of Privacy Practices.

Who are you requesting this data for?

Requester Information:
- I am filling out this form for myself
- I am filling out this form for someone else

Requestee Information:

Your Information:

Your Information:

All fields are required.
Your Information: First Name:
Your Information: Last Name:
Your Information: Request Type:
Request Type:
- Access My Info
- Delete My Info
- Do Not Sell My Info - to modify your cookie preferences, visit the Cookie Preferences page
- Withdraw Consent for Minors
Your Information: Response Preference:
Response Preference:
- Email
- Paper (via USPS Mail)
Your Information: Date of Birth:

Birth Month

Birth Day

Birth Year
Your Information: Email Address:
Your Information: Phone Number:
Your Information: Preferred Contact Time:
Your Information: Preferred Contact Time:
- Morning
- Afternoon
- Evening
Your Information: Preferred Contact Method:
Your Information: Preferred Contact Method:
- Email
- Phone
Copy requestee address Same as Requester:
- Same as Requestee
Your Information: Street Address
(Line 1)
Your Information: Street Address
(Line 2):
Your Information: City:
Your Information: State:
Your Information: Zip/Postal Code:
Penalty of Perjury:
Penalty of Perjury:
- I declare under penalty of perjury under the laws of the State of California that the foregoing information is true and correct.

Captcha:

Captcha:

Need Assistance?

Call (855) 771-4220 to submit a consumer rights request.

Call (855) 771-4220

Cookie Preferences

View and manage your cookie preferences.

Cookie Preferences

Our Privacy Policy

Review our privacy policy to learn how we use and collect your information.

The Sutter Health Network of Care

Expertise to fit your needs

Primary Care

Check-ups, screenings and sick visits for adults and children.

Specialty Care

Expertise and advanced technologies in all areas of medicine.

Emergency Care

For serious accidents, injuries and conditions that require immediate medical care.

Urgent Care

After-hours, weekend and holiday services.

Walk-In Care

Convenient walk-in care clinics for your non-urgent health needs.

ADA Accessibility
Contact
Privacy
Do Not Sell My Info

LinkedIn Opens new window
YouTube Opens new window
Facebook Opens new window
Twitter Opens new window
Glassdoor Opens new window
Instagram Opens new window

Cookie Policy

We use cookies to give you the best possible user experience. By clicking on "Accept Cookies", closing this pop-up banner or by continuing to use the site, you agree to the use of cookies. Privacy Policy Cookie Preferences

We've expanded your view

Privacy Request Form: Do Not Sell My Info

Consumer Rights Request

Your Information:

Need Assistance?

Cookie Preferences

Our Privacy Policy

About Sutter

Find Care

Featured Services

Patient Resources

Our Team