Colorado Privacy Appeal

Use this form to appeal Pidoxa's refusal, in whole or in part, to act on a Colorado privacy-rights request. Please provide your original request reference number and explain why you believe the decision should be reconsidered.

To submit a new privacy-rights request, use our Privacy Rights Request form. To exercise an opt-out right, use our Privacy Choices form.

Original request reference number

Full name

Email address used for the original request

State of residence This form is for Colorado privacy-rights appeals only.

Date of Pidoxa's decision

Original request type

Decision being appealed

Why the decision should be reconsidered

Additional information supporting the appeal (opt)

Copy of the original decision (opt)

Requested resolution (opt)

Requester

I am the consumer.

I am the consumer's authorized agent.

Authorized agent information

Agent's full name

Agent's organization (opt)

Agent's email

Agent's telephone number (opt)

Consumer's full name

Consumer's email

Signed authorization (required unless power of attorney applies)

Valid power of attorney

Yes

Consumer may be contacted directly.

I certify that the information in this appeal is accurate and that I am the consumer identified above or am authorized to submit this appeal on the consumer's behalf.