Consumer Rights Request Form

Submit Your Request

FMI values your privacy rights. If you are a California resident, you have the right to submit certain requests regarding your personal information (as defined under our CA Privacy Notice), no more than twice within a twelve (12) month period. You may submit such a request by completing the form below, which will help us to verify your identity, clarify the details of your request, and establish how we communicate with you. We will use the information you provide here solely in the context of responding to your consumer rights request. We will be unable to respond to your request if we cannot verify your identity or confirm your authority to make such a request.

You may also submit a request by calling us toll free at +1 (888)-988-3639, or by sending an email to privacy@foundationmedicine.com.

Please fill out the below Foundation Medicine Inc. (FMI)’s California Consumer Rights Request form and describe your request.  This form is directed at California Consumers who have certain rights under CA laws.

If some cases, we may need to contact you and request additional information to verify your identity before processing your request. Additionally, depending on the scope of your request, we may be limited in how we can respond.

Information collected via this form and related to your request will be handled by FMI’s applicable personnel. Information provided on this form is not intended to be used for any other purpose or shared with other parties unless necessary to fulfill your request.

For additional information about your CA Consumer rights, please visit our California Privacy Notice.  If you do not wish use this form, you may submit your request by calling us at : (888) 988-3639 (available only during regular business hours).

Section 1: Identification


Are you making this request on your own or another's behalf (if on behalf of another, include information about your relationship to the CA Consumer about whom the records relate)*

Please provide at least one form of contact information (i.e., email, telephone number, or residential address)

We will use this information to request additional documentation to verify or clarify your request.  We may also use this information for preliminary identification and verification of your records in our systems (depending on the nature of your request).  For this reason, it is recommended that you provide the contact information that we are most likely to have on file to help us confirm your identity and fulfill your request.


Section 2: Request Details

Please provide details about your request.

What type of request are you making?

Note that Foundation Medicine may be limited in the extent to which it can fulfill some types of requests. If you are requesting that we erase your personal information, we will need to contact you to confirm your request.

I’d Like to Learn More About Foundation Medicine

Details about how we process your information are available in our Privacy Policy.