Data Subject Request form in line with GDPR for EU data subjects

Please provide the following details to process the data subject request

Section – I: Are you making this request for information for yourself*?
Yes - Please proceed to Section IV (Section II and III are not required)
No - Please complete all the sections of this form

Section – II: If you are making this request on behalf of someone else, please state the nature of your relationship with that person (data subject*).
Parent
Guardian
Legal Representative
Others - Please mention

Section – III: If you are making this request on behalf of someone else, please provide the following information about yourself:
Name :
Contact Number :
Email id :
Section – IV: Please complete the following section, providing information about the data subject*
Name :
Registered Contact Number :
Registered email Id :
Type of Service / Product being used :
Country
Type of request :-
Please select from list below and mention the details :-
A. General requests*
Deletion of account
Unsubscribe from services such as Newsletters, alerts etc.

B. Data subject rights requests applicable to EU data subjects with respect to GDPR
Right of access
Right to rectification
Right to erasure (‘right to be forgotten’)
Right to restriction of processing
Right to data portability
Right to object
Automated individual decision-making, including profiling
Others

Section-V: Information to assist us in identifying your personal data*
Please provide details of the accounts/services (website name/service/ mobile application, account name, email ID, phone number etc.) you hold with this website for which you are creating a request
Section – VI: What information are you seeking*?
Please describe the information you are seeking in the below box.
Please provide any relevant details you think will help us to identify the information you require (such as details of services that have to be unsubscribed/deletion of account etc.)
*Data subject - A legal/natural person for whom the request is being raised
Section – VII: Attachments (For verification purpose)*
Please attach your valid ID proof. This is required for verification purposes. If you are making the request on behalf of the data subject, kindly attach the entitlement proof (such as letter of authority, evidence of parental responsibility etc.) letter and your valid ID proof.
Proof of ID for actual user :- Clear Image *Acceptable identity proof- passport, visa, nationality ID card
Entitlement proof for user other than the actual data subject :- Clear Image
The information you provide in this form will be used for the purpose of validating the authenticity of requestor and responding to this request. It is the user’s obligation to ensure the accuracy and correctness of the information provided while raising a request. Onlymyhealth will not be liable on account of any inaccuracy of information on this form.
To know more about privacy policy at Onlymyhealth please visit our website Link.

Data Subject Request form in line with GDPR for EU data subjects

Please provide the following details to process the data subject request

Type of request :-