Submit a Privacy Request

By using this form, you can request to exercise privacy rights, which can vary based on your jurisdiction. You may also submit a request to exercise these rights by emailing us at privacy@revance.com. For more information, please see our privacy notice.

Instructions

Please complete all required fields.*

If you are making a request on behalf of yourself, enter your own information. If you are an authorized agent submitting a request on behalf of someone else, enter that person's information.

I am:*

Submitting a request on behalf of myself Submitting a request on behalf of another as their authorized agent

Choose the category that best describes you:*

Patient/Consumer Health care professional Revance employee, applicant, or former workforce member Revance vendor or other business contact

Please select the type of available request you wish to make (and please see our privacy policy for more information on what rights we afford and do not afford).*

Request to know/access personal information collected

Request deletion of personal information

Request correction of personal information

Request to withdraw consent to process your personal information

Request to limit the use and disclosure of your sensitive personal information

Request your personal information in a portable, usable format

Request to appeal our decision regarding a request

Revance does not engage in the sale or sharing of your personal information/profiling or automated decision making, therefore we do not offer this right.

Please describe the information you wish to exercise rights over. Please provide any relevant details you think will help us to identify the information.*

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By submitting this form, you agree, on penalty of perjury or other criminal offense under applicable law, either that you are the individual about whom this request for personal information relates, or that you are authorized by that individual to submit this request on their behalf.