Welcome to Assurance IQ’s Data Request Form!

If you are a California resident submitting an access or deletion request pursuant to the California Consumer Privacy Act / California Privacy Rights Act (CCPA/CPRA), you may exercise your rights by completing this Data Request Form or contacting us at 1-844-311-6099. Non-California residents do not have such rights under the CCPA/CPRA.

The security of your information is important to Assurance IQ. We collect the information below solely to attempt to authenticate your identity and retrieve information for purposes of processing your data request.

Please populate the Form with the information you used during your interaction(s) with Assurance IQ. While Assurance will do all it can to honor your request, we may not be able to in certain circumstances. For example, if we cannot identify you within our systems, we will not be able to honor your request.

To learn more, please visit our Privacy Center

Error: Please enter first name
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Error: Please select how you interacted with Assurance
Error: Please select a date no earlier than January 1, 2022
Data Request Type
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