LLS Privacy Request

We understand that in this digital age, your and your loved ones' personal information is valuable and important to protect. If you have concerns, you can use this form. You can submit requests to either have your personal information removed from our systems or you can receive a copy of your information from our systems. This form can also be used to request that LLS does not share your personal information with third parties.

( * Indicates a required field)

Request Type *

What is being requested? Choose one type from the dropdown.

Relationship to Requester *

Referencing the field above, what is the relationship to the requester?

First Name *

The first name of the person making this request for the person whose information is involved.

Last Name *

The last name of the person making this request for the person whose information is involved.

Email *

An email address of the person making this request for the person whose information is involved.

Phone *

A phone number of the person making this request for the person whose information is involved.

Please provide the following information on the individual you are requesting action for:

First Name *

The first name of the person whose information is involved.

Last Name *

The last name of the person whose information is involved.

Email Address *

An email address for the person whose information is involved.

Street Address *

The street address of the person whose information is involved.

City *

The city or town where the person whose information is involved resides.

State *

The state where the person whose information is involved resides. Choose one state from the dropdown.

Postal Code *

The postal code where the person whose information is involved resides.

Phone *

A telephone number for the person whose information is involved.