DATA REQUEST FORM

This Data Request Form is solely for CCPA information. If you wish to receive a copy of your test results or have questions about a bill, please send an email to [email protected] or submit this form

Exagen Inc. values your privacy. If you would like to submit a request pertaining to your data, please complete the form below. The request will be handled based on the information you provide us. Please note, if you have multiple email addresses or phone numbers that you have used with us and would like to make a request for each one, you must submit a separate request for each.

  • Please let us know in the comment form above the nature of your data request.
    I understand after hitting submit, I will receive an automated email to confirm my data request and I must respond to the email with "I approve" in order for my request to be processed.

This information will be used to process your CCPA request and for no other purpose. Exagen Inc. will maintain a record of your request pursuant to Civil Code section 1798.105(d).