Welcome! If you are a resident of Colorado and would like to exercise your privacy rights, you can complete this form to submit your request.


If you are a patient of a Provider and wish to exercise your rights, you must contact your Provider, not Artera.


For additional information, please visit the Privacy Policy. Thank you.


Authorized Agent
Consumer - Household
Minor
Consumer-Individual
Guardian/Parent
None of the above
Enter the first name of the data subject
Enter the last name of the data subject
Enter email for correspondence with the data request.
Enter any additional information in this section that will help us process your request. Please refrain from entering any personal information.

By submitting this form I confirm I am a resident of Colorado and that the information I have provided is accurate.

If you have any documentation in support of your request, please attach it using the button below