{"id":4502,"date":"2025-10-22T20:26:04","date_gmt":"2025-10-22T20:26:04","guid":{"rendered":"https:\/\/proximitywedev.wpenginepowered.com\/?page_id=4502"},"modified":"2025-10-22T22:39:49","modified_gmt":"2025-10-22T22:39:49","slug":"data-subject-request-form","status":"publish","type":"page","link":"https:\/\/proximity2edc.com\/?page_id=4502","title":{"rendered":"Data Subject Request Form"},"content":{"rendered":"<h5><strong>Data Subject Request\u00a0<\/strong><\/h5>\n<hr \/>\n<p><span>Please enter the following information below for us to process your Data Subject Request.<\/span><\/p>\n<div class=\"wpforms-container wpforms-container-full\" id=\"wpforms-4501\"><form id=\"wpforms-form-4501\" class=\"wpforms-validate wpforms-form wpforms-ajax-form\" data-formid=\"4501\" method=\"post\" enctype=\"multipart\/form-data\" action=\"\/index.php?rest_route=%2Fwp%2Fv2%2Fpages%2F4502\" data-token=\"faf6f0bd2b7c6ca2830f2c3e0b9c4066\" data-token-time=\"1776770461\"><noscript class=\"wpforms-error-noscript\">Please enable JavaScript in your browser to complete this form.<\/noscript><div class=\"wpforms-field-container\"><div id=\"wpforms-4501-field_0-container\" class=\"wpforms-field wpforms-field-name\" data-field-id=\"0\"><label class=\"wpforms-field-label\">Name <span class=\"wpforms-required-label\">*<\/span><\/label><div class=\"wpforms-field-row wpforms-field-large\"><div class=\"wpforms-field-row-block wpforms-first wpforms-one-half\"><input type=\"text\" id=\"wpforms-4501-field_0\" class=\"wpforms-field-name-first wpforms-field-required\" name=\"wpforms[fields][0][first]\" required><label for=\"wpforms-4501-field_0\" class=\"wpforms-field-sublabel after\">First<\/label><\/div><div class=\"wpforms-field-row-block wpforms-one-half\"><input type=\"text\" id=\"wpforms-4501-field_0-last\" class=\"wpforms-field-name-last wpforms-field-required\" name=\"wpforms[fields][0][last]\" required><label for=\"wpforms-4501-field_0-last\" class=\"wpforms-field-sublabel after\">Last<\/label><\/div><\/div><\/div><div id=\"wpforms-4501-field_13-container\" class=\"wpforms-field wpforms-field-email\" data-field-id=\"13\"><label class=\"wpforms-field-label\" for=\"wpforms-4501-field_13\">Email <span class=\"wpforms-required-label\">*<\/span><\/label><input type=\"email\" id=\"wpforms-4501-field_13\" class=\"wpforms-field-large wpforms-field-required\" name=\"wpforms[fields][13]\" spellcheck=\"false\" required><\/div>\t\t<div id=\"wpforms-4501-field_1-container\"\n\t\t\tclass=\"wpforms-field wpforms-field-text\"\n\t\t\tdata-field-type=\"text\"\n\t\t\tdata-field-id=\"1\"\n\t\t\t>\n\t\t\t<label class=\"wpforms-field-label\" for=\"wpforms-4501-field_1\" >Type Request Request<\/label>\n\t\t\t<input type=\"text\" id=\"wpforms-4501-field_1\" class=\"wpforms-field-medium\" name=\"wpforms[fields][1]\" >\n\t\t<\/div>\n\t\t<div id=\"wpforms-4501-field_5-container\" class=\"wpforms-field wpforms-field-text\" data-field-id=\"5\"><label class=\"wpforms-field-label\" for=\"wpforms-4501-field_5\">Phone <span class=\"wpforms-required-label\">*<\/span><\/label><input type=\"text\" id=\"wpforms-4501-field_5\" class=\"wpforms-field-large wpforms-field-required\" name=\"wpforms[fields][5]\" required><\/div><div id=\"wpforms-4501-field_6-container\" class=\"wpforms-field wpforms-field-select wpforms-conditional-trigger wpforms-field-select-style-classic\" data-field-id=\"6\"><label class=\"wpforms-field-label\" for=\"wpforms-4501-field_6\">Request Type <span class=\"wpforms-required-label\">*<\/span><\/label><select id=\"wpforms-4501-field_6\" class=\"wpforms-field-large wpforms-field-required\" name=\"wpforms[fields][6]\" required=\"required\"><option value=\"\" class=\"placeholder\" disabled  selected='selected'>-Please select-<\/option><option value=\"Right to be Informed\"  class=\"choice-1 depth-1\"  >Right to be Informed<\/option><option value=\"Right to Access\"  class=\"choice-2 depth-1\"  >Right to Access<\/option><option value=\"Right to Rectification\"  class=\"choice-3 depth-1\"  >Right to Rectification<\/option><option value=\"Right to Erasure (Right to be Forgotten)\"  class=\"choice-4 depth-1\"  >Right to Erasure (Right to be Forgotten)<\/option><option value=\"Right to Portability\"  class=\"choice-5 depth-1\"  >Right to Portability<\/option><option value=\"Right to Restriction of Processing\"  class=\"choice-6 depth-1\"  >Right to Restriction of Processing<\/option><option value=\"Right to Object\"  class=\"choice-7 depth-1\"  >Right to Object<\/option><option value=\"Right in Relation to Automated Decision Making and Profiling\"  class=\"choice-8 depth-1\"  >Right in Relation to Automated Decision Making and Profiling<\/option><\/select><\/div><div id=\"wpforms-4501-field_11-container\" class=\"wpforms-field wpforms-field-textarea wpforms-conditional-field wpforms-conditional-show\" data-field-id=\"11\" style=\"display:none;\"><label class=\"wpforms-field-label\" for=\"wpforms-4501-field_11\">Request Details and\/or Instructions <span class=\"wpforms-required-label\">*<\/span><\/label><textarea id=\"wpforms-4501-field_11\" class=\"wpforms-field-medium wpforms-field-required wpforms-limit-characters-enabled\" data-form-id=\"4501\" data-field-id=\"11\" data-text-limit=\"1000\" name=\"wpforms[fields][11]\" maxlength=\"1000\" required><\/textarea><div class=\"wpforms-field-description\">Right to be Informed: You have the right to know how your personal data is being collected, used, stored, and shared. This includes details about the data controller, purposes of processing, data retention, and rights.<\/div><\/div><div id=\"wpforms-4501-field_14-container\" class=\"wpforms-field wpforms-field-textarea wpforms-conditional-field wpforms-conditional-show\" data-field-id=\"14\" style=\"display:none;\"><label class=\"wpforms-field-label\" for=\"wpforms-4501-field_14\">Request Details and\/or Instructions <span class=\"wpforms-required-label\">*<\/span><\/label><textarea id=\"wpforms-4501-field_14\" class=\"wpforms-field-medium wpforms-field-required wpforms-limit-characters-enabled\" data-form-id=\"4501\" data-field-id=\"14\" data-text-limit=\"1000\" name=\"wpforms[fields][14]\" maxlength=\"1000\" required><\/textarea><div class=\"wpforms-field-description\">Right to Access: You have the right to request access to the personal data we hold about you. This means you can ask for details about what personal information is being processed, why it's being processed, and who it's being shared with.<\/div><\/div><div id=\"wpforms-4501-field_15-container\" class=\"wpforms-field wpforms-field-textarea wpforms-conditional-field wpforms-conditional-show\" data-field-id=\"15\" style=\"display:none;\"><label class=\"wpforms-field-label\" for=\"wpforms-4501-field_15\">Request Details and\/or Instructions <span class=\"wpforms-required-label\">*<\/span><\/label><textarea id=\"wpforms-4501-field_15\" class=\"wpforms-field-medium wpforms-field-required wpforms-limit-characters-enabled\" data-form-id=\"4501\" data-field-id=\"15\" data-text-limit=\"1000\" name=\"wpforms[fields][15]\" maxlength=\"1000\" required><\/textarea><div class=\"wpforms-field-description\">Right to Rectification: You have the right to request the correction or updating of inaccurate or incomplete personal data.<\/div><\/div><div id=\"wpforms-4501-field_16-container\" class=\"wpforms-field wpforms-field-textarea wpforms-conditional-field wpforms-conditional-show\" data-field-id=\"16\" style=\"display:none;\"><label class=\"wpforms-field-label\" for=\"wpforms-4501-field_16\">Request Details and\/or Instructions <span class=\"wpforms-required-label\">*<\/span><\/label><textarea id=\"wpforms-4501-field_16\" class=\"wpforms-field-medium wpforms-field-required wpforms-limit-characters-enabled\" data-form-id=\"4501\" data-field-id=\"16\" data-text-limit=\"1000\" name=\"wpforms[fields][16]\" maxlength=\"1000\" required><\/textarea><div class=\"wpforms-field-description\">Right to Erasure (Right to be Forgotten): You have the right to request the deletion or removal of your personal data when there is no compelling reason for its continued processing. This allows you to have more control over your online presence and to remove outdated or irrelevant information.<\/div><\/div><div id=\"wpforms-4501-field_17-container\" class=\"wpforms-field wpforms-field-textarea wpforms-conditional-field wpforms-conditional-show\" data-field-id=\"17\" style=\"display:none;\"><label class=\"wpforms-field-label\" for=\"wpforms-4501-field_17\">Request Details and\/or Instructions <span class=\"wpforms-required-label\">*<\/span><\/label><textarea id=\"wpforms-4501-field_17\" class=\"wpforms-field-medium wpforms-field-required wpforms-limit-characters-enabled\" data-form-id=\"4501\" data-field-id=\"17\" data-text-limit=\"1000\" name=\"wpforms[fields][17]\" maxlength=\"1000\" required><\/textarea><div class=\"wpforms-field-description\">Right to Data Portability: You have the right to receive a copy of your personal data in a commonly used, machine-readable format and to transmit that data to another organization as you see fit.<\/div><\/div><div id=\"wpforms-4501-field_18-container\" class=\"wpforms-field wpforms-field-textarea wpforms-conditional-field wpforms-conditional-show\" data-field-id=\"18\" style=\"display:none;\"><label class=\"wpforms-field-label\" for=\"wpforms-4501-field_18\">Request Details and\/or Instructions <span class=\"wpforms-required-label\">*<\/span><\/label><textarea id=\"wpforms-4501-field_18\" class=\"wpforms-field-medium wpforms-field-required wpforms-limit-characters-enabled\" data-form-id=\"4501\" data-field-id=\"18\" data-text-limit=\"1000\" name=\"wpforms[fields][18]\" maxlength=\"1000\" required><\/textarea><div class=\"wpforms-field-description\">Right to Restriction of Processing: You have the right to limit the processing of your personal data under certain circumstances, such as when the accuracy of the data is contested or the processing is unlawful.<\/div><\/div><div id=\"wpforms-4501-field_19-container\" class=\"wpforms-field wpforms-field-textarea wpforms-conditional-field wpforms-conditional-show\" data-field-id=\"19\" style=\"display:none;\"><label class=\"wpforms-field-label\" for=\"wpforms-4501-field_19\">Request Details and\/or Instructions <span class=\"wpforms-required-label\">*<\/span><\/label><textarea id=\"wpforms-4501-field_19\" class=\"wpforms-field-medium wpforms-field-required wpforms-limit-characters-enabled\" data-form-id=\"4501\" data-field-id=\"19\" data-text-limit=\"1000\" name=\"wpforms[fields][19]\" maxlength=\"1000\" required><\/textarea><div class=\"wpforms-field-description\">Right to Object: You have the right to object to the processing of your personal data in certain situations, such as for direct marketing purposes. This gives you the ability to prevent your data from being used in ways that you find intrusive or objectionable.<\/div><\/div><div id=\"wpforms-4501-field_20-container\" class=\"wpforms-field wpforms-field-textarea wpforms-conditional-field wpforms-conditional-show\" data-field-id=\"20\" style=\"display:none;\"><label class=\"wpforms-field-label\" for=\"wpforms-4501-field_20\">Request Details and\/or Instructions (copy) <span class=\"wpforms-required-label\">*<\/span><\/label><textarea id=\"wpforms-4501-field_20\" class=\"wpforms-field-medium wpforms-field-required wpforms-limit-characters-enabled\" data-form-id=\"4501\" data-field-id=\"20\" data-text-limit=\"1000\" name=\"wpforms[fields][20]\" maxlength=\"1000\" required><\/textarea><div class=\"wpforms-field-description\">Right to Object: You have the right to object to the processing of your personal data in certain situations, such as for direct marketing purposes. This gives you the ability to prevent your data from being used in ways that you find intrusive or objectionable.<\/div><\/div><div id=\"wpforms-4501-field_9-container\" class=\"wpforms-field wpforms-field-checkbox\" data-field-id=\"9\"><label class=\"wpforms-field-label\">Consent <span class=\"wpforms-required-label\">*<\/span><\/label><ul id=\"wpforms-4501-field_9\" class=\"wpforms-field-required\"><li class=\"choice-1 depth-1\"><input type=\"checkbox\" id=\"wpforms-4501-field_9_1\" name=\"wpforms[fields][9][]\" value=\"By selecting this, You agree that Equicare must confirm a Data Subject\u2019s identity before responding to such request. Equicare shall not start processing the DSR until proof of identity is verified.\" required ><label class=\"wpforms-field-label-inline\" for=\"wpforms-4501-field_9_1\">By selecting this, You agree that Equicare must confirm a Data Subject\u2019s identity before responding to such request. Equicare shall not start processing the DSR until proof of identity is verified.<\/label><\/li><\/ul><\/div><script>\n\t\t\t\t( function() {\n\t\t\t\t\tconst style = document.createElement( 'style' );\n\t\t\t\t\tstyle.appendChild( document.createTextNode( '#wpforms-4501-field_1-container { position: absolute !important; overflow: hidden !important; display: inline !important; height: 1px !important; width: 1px !important; z-index: -1000 !important; padding: 0 !important; } #wpforms-4501-field_1-container input { visibility: hidden; } #wpforms-conversational-form-page #wpforms-4501-field_1-container label { counter-increment: none; }' ) );\n\t\t\t\t\tdocument.head.appendChild( style );\n\t\t\t\t\tdocument.currentScript?.remove();\n\t\t\t\t} )();\n\t\t\t<\/script><\/div><!-- .wpforms-field-container --><div class=\"wpforms-submit-container\" ><input type=\"hidden\" name=\"wpforms[id]\" value=\"4501\"><input type=\"hidden\" name=\"page_title\" value=\"\"><input type=\"hidden\" name=\"page_url\" value=\"https:\/\/proximity2edc.com\/index.php?rest_route=\/wp\/v2\/pages\/4502\"><input type=\"hidden\" name=\"url_referer\" value=\"\"><button type=\"submit\" name=\"wpforms[submit]\" id=\"wpforms-submit-4501\" class=\"wpforms-submit\" data-alt-text=\"Sending...\" data-submit-text=\"Submit\" aria-live=\"assertive\" value=\"wpforms-submit\">Submit<\/button><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/proximity2edc.com\/wp-content\/plugins\/wpforms\/assets\/images\/submit-spin.svg\" class=\"wpforms-submit-spinner\" style=\"display: none;\" width=\"26\" height=\"26\" alt=\"Loading\"><\/div><\/form><\/div>  <!-- .wpforms-container -->\n","protected":false},"excerpt":{"rendered":"<p>Data Subject Request\u00a0 Please enter the following information below for us to process your Data Subject Request.<\/p>\n","protected":false},"author":4,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_themeisle_gutenberg_block_has_review":false,"footnotes":""},"class_list":["post-4502","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/proximity2edc.com\/index.php?rest_route=\/wp\/v2\/pages\/4502","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/proximity2edc.com\/index.php?rest_route=\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/proximity2edc.com\/index.php?rest_route=\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/proximity2edc.com\/index.php?rest_route=\/wp\/v2\/users\/4"}],"replies":[{"embeddable":true,"href":"https:\/\/proximity2edc.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=4502"}],"version-history":[{"count":0,"href":"https:\/\/proximity2edc.com\/index.php?rest_route=\/wp\/v2\/pages\/4502\/revisions"}],"wp:attachment":[{"href":"https:\/\/proximity2edc.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=4502"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}