CCPA Verifiable Request Form

Identifying Information

Best method to contact you:

Are you an authorized agent submitting this request on behalf of a resident of California?

Yes

Are you, or if making a request as an authorized agent the individual on whose behalf you are acting, a resident of California?

Yes

Request

1. To Update Information. I would like Vericel to update my personal information in accordance with the following:

2. To Delete (please select only ONE option). Vericel will contact you prior to deletion to verify your identity and confirm your request:

I request that Vericel delete all of the Personally Identifiable Information Vericel, and third-party affiliates acting on behalf of Vericel, have collected about me.

I request that Vericel delete the following categories of Personally Identifiable Information Vericel, and third-party affiliates acting on behalf of Vericel, have collected about me:

Identifying information including, but not limited to, name, address, and email;

Internet or other electronic network activity

I would like Vericel to delete the following pieces of Personally Identifiable Information that Vericel, and third-party affiliates acting on behalf of Vericel, have collected about me:

3. To Know. I request Vericel send me:

The categories of Personally Identifiable Information Vericel has collected about me in the past 12 months

The specific pieces of Personally Identifiable Information Vericel has collected about me

The business or commercial purpose for the collection of my Personally Identifiable Information

The categories of third-parties with whom Vericel has shared by Personally Identifiable Information, if applicable

4. Copy of Vericel’s Privacy Policy:

As an individual with a disability I have the right to request that Vericel send me an alternate format of its Privacy Policy. By checking this box, I request that Vericel contact me through the above-selected method to provide me with Vericel’s Privacy Policy in an alternate format. Vericel will contact you for more information or notify you of the status of your request within 10 days of receipt. Vericel will provide you with an update or complete your request within 45 days of receipt.

Certification

I certify that that I am the above-named individual or an authorized agent acting on behalf of the above-named individual and that all information provided as part of this Vericel Personal Information Request form is true and correct to the best of my knowledge.

I give my consent to Vericel and its Service Providers, as defined in Vericel’s Privacy Policy, to use this information to complete my request.

Vericel California Consumer Privacy Act Personal Information Request