Data Subject Right Request Form

You may utilize this form to make requests with respect to your personal information, or the personal information of someone else on their behalf (e.g. dependent), that Medtronic has collected about you/them. In order to assess that request, please complete all required sections below.

If you choose not to provide the information marked with an “*” (indicating a required field) it may not be possible to verify your identity or properly direct your request.

* Indicates a required field.

Individual / Data Subject: The person whose personal information is being requested

Are you making this request on behalf of another person?

Please provide details about your relationship to Medtronic (or the relationship to Medtronic of the individual / data subject to whom this request relates):*





Associated product, therapy, or service that Medtronic provides to you
This information is critical to help us quickly and accurately fulfill your request
*You must select one or more of the following in order to submit your request.
Note: Please see the treatments and therapies page for more information about each category.

 
 
 
 
 
 
 
 
 
 
 
Please provide the website address where you log in:
 
Please describe to the best of your knowledge:
If known, please add the approximate dates that you believe your data has been processed by Medtronic:

Type of Request — What would you like Medtronic to do?*


Please indicate how you want Medtronic to communicate with you regarding your request.
If you do not make a selection, Medtronic will use Email.



Please note: We may need to request additional information to verify your identity or to fulfill your request. For more information on how we manage and protect your personal information, please see our Privacy Statement.