Privacy Rights Request Form

Country*

Are you a California Resident?*

Yes (CA Resident)
No (not a CA Resident)

State*

European Country*

Enter Country*

Please indicate your relationship with Travere Therapeutics.*

I am a current customer or patient
I am a former customer or patient
I am an employee
I am a prospective employee
I am a contractor
I am a authorized agent requesting on behalf of a consumer

Select request type(s)*

Select request type*

Information Request
Data Deletion
Update Data
Opt out
Object to Processing
Restrict Processing

Select request type*

Name*

First Last

Email*

Enter Email Confirm Email

Address (United States)*

Street Address Address Line 2 City State ZIP Code

Address (International)*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone (United States)

Phone (International)

Request Details*

Please provide additional details of the specific data privacy rights request or personal data you seek.

Additional information*

Please describe your relationship with Travere Therapeutics, formerly known as Retrophin, and how you have interacted with Travere Therapeutics and include relevant dates. (Please be specific). [For example: Travere product you used/inquired about, relevant disease state you've contacted Travere about, etc.]

Consent*

I understand that by checking this box and clicking "Submit", I am submitting my contact information to Travere.
All personal data provided on this form will be used by or on behalf of Travere to process and respond to your request. Travere will retain personal data only for as long as is required to complete the purposes for which it was collected and to fulfil its legal, regulatory, or reporting obligations. Travere understands personal data is private and will not disseminate it to third parties who are not providing services to Travere. For more information, review the Travere privacy policies.*

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PRIVACY RIGHTS REQUEST FORM