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725 Canton Street, Norwood, MA 02062 - 617.581.1900 Ext 2456

CCPA Request Form

This form is used for the sole purpose of requesting information under the California Consumer Privacy Act of 2018 ("CCPA"). If you are not a resident of California or would like to contact us for any other purpose, then please refer to the notice you received from this office, use the contact information located above, or visit our self-service website:

Please provide the following information:
Please select at least one request:

Fields marked with an asterisk (*) are mandatory.

View ClaimAssist Privacy Policy

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