Arcutis Biotherapeutics

Privacy Request Form

Welcome! This Privacy Request Form allows consumers in states with U.S. Privacy Laws to submit privacy rights requests to Arcutis Biotherapeutics, Inc. The privacy rights available to you may vary depending on your state of residence. To submit a request to exercise your privacy rights, please select and enter the appropriate fields on this form. If applicable, Arcutis will take steps to verify your identity and affiliation with us and may request additional information from you to verify your identity or as necessary to process your request.

Arcutis will use reasonable efforts to provide you with appropriate information related to your request. In the event we cannot honor your request, we will explain why we cannot do so.

If you are a clinical trial subject, please contact the Principal Investigator on the relevant study.

We will contact you if we need any additional information.

California Notice of Right to Opt Out of Sales/Share and Limit Use of Sensitive Personal Information: Residents of California have the right to opt-out of the sale/sharing of their personal information and the right to limit the use of their Sensitive Personal Information to the purposes authorized by the CCPA. To exercise these rights, please fill out the form below or call us toll free at 844-4ARCUTIS.

“*” indicates required fields

Select Request Type*

Please select the date range for your request: (choose one)*

My request relates to all Personal Information collected about me

My request relates to Personal Information collected about me between specific dates

Date range for your request:

Start Date*

End Date*

On whose behalf are you submitting this request?*

Myself

As an authorized agent on behalf of someone else

Authorized agent’s first name*

Authorized agent’s last name*

Authorized agent’s email address*

I am a(n)*

Name*

Email*

(Please use the email address you have previously provided to Arcutis)

Phone*

(Please use the phone number you have previously provided to Arcutis)

Consent*

I acknowledge that Arcutis will collect, use, and disclose my personal information in accordance with the Arcutis Privacy Notice.*

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For further information please view our U.S. State Supplemental Privacy Notice or contact Arcutis Privacy at privacy@arcutis.com

This page is intended for U.S. residents only.