{"id":1620,"date":"2025-11-04T04:10:25","date_gmt":"2025-11-04T04:10:25","guid":{"rendered":"https:\/\/optiwellness.net\/?page_id=1620"},"modified":"2025-11-04T05:05:17","modified_gmt":"2025-11-04T05:05:17","slug":"privacy-request","status":"publish","type":"page","link":"https:\/\/optiwellness.net\/es\/privacy-request\/","title":{"rendered":"Privacy Request"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"1620\" class=\"elementor elementor-1620\" data-elementor-post-type=\"page\">\n\t\t\t\t<div class=\"elementor-element elementor-element-0583b29 e-flex e-con-boxed e-con e-parent\" data-id=\"0583b29\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;ekit_has_onepagescroll_dot&quot;:&quot;yes&quot;}\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-34f2c17 elementor-widget elementor-widget-heading\" data-id=\"34f2c17\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;ekit_we_effect_on&quot;:&quot;none&quot;}\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">US State Resident Data Rights Request Form<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-b55a131 e-flex e-con-boxed e-con e-parent\" data-id=\"b55a131\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;ekit_has_onepagescroll_dot&quot;:&quot;yes&quot;}\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-2cd1cec elementor-widget elementor-widget-text-editor\" data-id=\"2cd1cec\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;ekit_we_effect_on&quot;:&quot;none&quot;}\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p data-start=\"525\" data-end=\"728\">If you are a resident of a U.S. state with a comprehensive consumer privacy law or a law governing the use of consumer health data, you may be able to exercise certain data rights under those state laws.<\/p><p data-start=\"730\" data-end=\"831\">Please complete this form to submit your U.S. State Resident Data Rights Request to <span style=\"color: #000000;\"><strong>OptiWellness<\/strong><\/span>.<\/p><p data-start=\"833\" data-end=\"1118\">In certain circumstances, we may require additional information if we are unable to verify your request based on the information provided.<br data-start=\"971\" data-end=\"974\" \/>The personal information submitted in connection with your request will be used solely for the purpose of processing and verifying your request.<\/p><p data-start=\"1120\" data-end=\"1191\"><strong data-start=\"1120\" data-end=\"1126\">*<\/strong> Fields marked with an asterisk are required to submit this form.<\/p><p data-start=\"1193\" data-end=\"1359\">Please also refer to the <span style=\"color: #000000;\"><strong data-start=\"1218\" data-end=\"1256\">\u201cAdChoices \/ Do Not Sell or Share\u201d<\/strong><\/span> link at the bottom of OptiWellness webpages to exercise your choices regarding browser based tracking.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-f1dcb98 e-flex e-con-boxed e-con e-parent\" data-id=\"f1dcb98\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;ekit_has_onepagescroll_dot&quot;:&quot;yes&quot;}\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-fd6ae56 elementor-button-align-stretch elementor-widget elementor-widget-form\" data-id=\"fd6ae56\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;step_next_label&quot;:&quot;Next&quot;,&quot;step_previous_label&quot;:&quot;Previous&quot;,&quot;button_width&quot;:&quot;100&quot;,&quot;step_type&quot;:&quot;number_text&quot;,&quot;step_icon_shape&quot;:&quot;circle&quot;,&quot;ekit_we_effect_on&quot;:&quot;none&quot;}\" data-widget_type=\"form.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<form class=\"elementor-form\" method=\"post\" name=\"privacy_request_form\" aria-label=\"privacy_request_form\">\n\t\t\t<input type=\"hidden\" name=\"post_id\" value=\"1620\"\/>\n\t\t\t<input type=\"hidden\" name=\"form_id\" value=\"fd6ae56\"\/>\n\t\t\t<input type=\"hidden\" name=\"referer_title\" value=\"Privacy Request - optiwellness.net\" \/>\n\n\t\t\t\t\t\t\t<input type=\"hidden\" name=\"queried_id\" value=\"1620\"\/>\n\t\t\t\n\t\t\t<div class=\"elementor-form-fields-wrapper elementor-labels-above\">\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-select elementor-field-group elementor-column elementor-field-group-request_type elementor-col-60 elementor-field-required elementor-mark-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-request_type\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tRequest Type\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field elementor-select-wrapper remove-before \">\n\t\t\t<div class=\"select-caret-down-wrapper\">\n\t\t\t\t<svg aria-hidden=\"true\" class=\"e-font-icon-svg e-eicon-caret-down\" viewBox=\"0 0 571.4 571.4\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M571 393Q571 407 561 418L311 668Q300 679 286 679T261 668L11 418Q0 407 0 393T11 368 36 357H536Q550 357 561 368T571 393Z\"><\/path><\/svg>\t\t\t<\/div>\n\t\t\t<select name=\"form_fields[request_type]\" id=\"form-field-request_type\" class=\"elementor-field-textual elementor-size-sm\" required=\"required\">\n\t\t\t\t\t\t\t\t\t<option value=\"- Data Access \/ Portability\">- Data Access \/ Portability<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"- Correct Data\">- Correct Data<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"- Delete Data\">- Delete Data<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"- Opt-out of Sale\/Share\">- Opt-out of Sale\/Share<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"- Limit Use of Sensitive Personal Information\">- Limit Use of Sensitive Personal Information<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"- Opt-out of Targeted Advertising\">- Opt-out of Targeted Advertising<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"- Appeal a Denied Request\">- Appeal a Denied Request<\/option>\n\t\t\t\t\t\t\t<\/select>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-first_name elementor-col-50 elementor-field-required elementor-mark-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-first_name\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tFirst Name\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[first_name]\" id=\"form-field-first_name\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" required=\"required\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-last_name elementor-col-50 elementor-field-required elementor-mark-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-last_name\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tLast Name\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[last_name]\" id=\"form-field-last_name\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" required=\"required\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-email elementor-field-group elementor-column elementor-field-group-email elementor-col-75 elementor-field-required elementor-mark-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-email\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tEmail Address\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"email\" name=\"form_fields[email]\" id=\"form-field-email\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" required=\"required\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-address elementor-col-75\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-address\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tAddress\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[address]\" id=\"form-field-address\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"Optional\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-address2 elementor-col-75\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-address2\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tAddress Line 2\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[address2]\" id=\"form-field-address2\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"Optional\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-city elementor-col-75\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-city\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tCity\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[city]\" id=\"form-field-city\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"Optional\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-select elementor-field-group elementor-column elementor-field-group-state elementor-col-75 elementor-field-required elementor-mark-required\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-state\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tState of Residence\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field elementor-select-wrapper remove-before \">\n\t\t\t<div class=\"select-caret-down-wrapper\">\n\t\t\t\t<svg aria-hidden=\"true\" class=\"e-font-icon-svg e-eicon-caret-down\" viewBox=\"0 0 571.4 571.4\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M571 393Q571 407 561 418L311 668Q300 679 286 679T261 668L11 418Q0 407 0 393T11 368 36 357H536Q550 357 561 368T571 393Z\"><\/path><\/svg>\t\t\t<\/div>\n\t\t\t<select name=\"form_fields[state]\" id=\"form-field-state\" class=\"elementor-field-textual elementor-size-sm\" required=\"required\">\n\t\t\t\t\t\t\t\t\t<option value=\"Alabama\">Alabama<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Alaska\">Alaska<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Arizona\">Arizona<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Arkansas\">Arkansas<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"California\">California<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Colorado\">Colorado<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Connecticut\">Connecticut<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Delaware\">Delaware<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"District of Columbia\">District of Columbia<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Florida\">Florida<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Georgia\">Georgia<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Hawaii\">Hawaii<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Idaho\">Idaho<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Illinois\">Illinois<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Indiana\">Indiana<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Iowa\">Iowa<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Kansas\">Kansas<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Kentucky\">Kentucky<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Louisiana\">Louisiana<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Maine\">Maine<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Maryland\">Maryland<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Massachusetts\">Massachusetts<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Michigan\">Michigan<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Minnesota\">Minnesota<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Mississippi\">Mississippi<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Missouri\">Missouri<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Montana\">Montana<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Nebraska\">Nebraska<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Nevada\">Nevada<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"New Hampshire\">New Hampshire<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"New Jersey\">New Jersey<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"New Mexico\">New Mexico<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"New York\">New York<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"North Carolina\">North Carolina<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"North Dakota\">North Dakota<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Ohio\">Ohio<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Oklahoma\">Oklahoma<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Oregon\">Oregon<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Pennsylvania\">Pennsylvania<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Rhode Island\">Rhode Island<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"South Carolina\">South Carolina<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"South Dakota\">South Dakota<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Tennessee\">Tennessee<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Texas\">Texas<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Utah\">Utah<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Vermont\">Vermont<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Virginia\">Virginia<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Washington\">Washington<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"West Virginia\">West Virginia<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Wisconsin\">Wisconsin<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Wyoming\">Wyoming<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Puerto Rico\">Puerto Rico<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"Guam\">Guam<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"American Samoa\">American Samoa<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"U.S. Virgin Islands\">U.S. Virgin Islands<\/option>\n\t\t\t\t\t\t\t\t\t<option value=\"\"><\/option>\n\t\t\t\t\t\t\t<\/select>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-zip elementor-col-75\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-zip\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tZip Code\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[zip]\" id=\"form-field-zip\" class=\"elementor-field elementor-size-sm  elementor-field-textual\" placeholder=\"Optional\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-checkbox elementor-field-group elementor-column elementor-field-group-us_resident elementor-col-75\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-us_resident\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tI am a U.S. Resident\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t<div class=\"elementor-field-subgroup  \"><span class=\"elementor-field-option\"><input type=\"checkbox\" value=\"\u201cYes\u201d\" id=\"form-field-us_resident-0\" name=\"form_fields[us_resident]\"> <label for=\"form-field-us_resident-0\">\u201cYes\u201d<\/label><\/span><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-radio elementor-field-group elementor-column elementor-field-group-authorized_agent elementor-col-75\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-authorized_agent\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tAre you an authorized agent?\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t<div class=\"elementor-field-subgroup  \"><span class=\"elementor-field-option\"><input type=\"radio\" value=\"Yes\" id=\"form-field-authorized_agent-0\" name=\"form_fields[authorized_agent]\"> <label for=\"form-field-authorized_agent-0\">Yes<\/label><\/span><span class=\"elementor-field-option\"><input type=\"radio\" value=\"No\" id=\"form-field-authorized_agent-1\" name=\"form_fields[authorized_agent]\"> <label for=\"form-field-authorized_agent-1\">No<\/label><\/span><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-agent_name elementor-col-75\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-agent_name\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tAgent Name\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[agent_name]\" id=\"form-field-agent_name\" class=\"elementor-field elementor-size-sm  elementor-field-textual\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-email elementor-field-group elementor-column elementor-field-group-agent_email elementor-col-100\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-agent_email\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tAgent Email\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"email\" name=\"form_fields[agent_email]\" id=\"form-field-agent_email\" class=\"elementor-field elementor-size-sm  elementor-field-textual\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-upload elementor-field-group elementor-column elementor-field-group-authorization_upload elementor-col-100\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-authorization_upload\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tUpload Authorization\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t<input type=\"file\" name=\"form_fields[authorization_upload]\" id=\"form-field-authorization_upload\" class=\"elementor-field elementor-size-sm  elementor-upload-field\">\n\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-text elementor-field-group elementor-column elementor-field-group-details elementor-col-100\">\n\t\t\t\t\t\t\t\t\t\t\t\t<label for=\"form-field-details\" class=\"elementor-field-label\">\n\t\t\t\t\t\t\t\tAdditional Details\t\t\t\t\t\t\t<\/label>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<input size=\"1\" type=\"text\" name=\"form_fields[details]\" id=\"form-field-details\" class=\"elementor-field elementor-size-sm  elementor-field-textual\">\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-type-recaptcha_v3 elementor-field-group elementor-column elementor-field-group-field_f9e545b elementor-col-100 recaptcha_v3-bottomright\">\n\t\t\t\t\t<div class=\"elementor-field\" id=\"form-field-field_f9e545b\"><div class=\"elementor-g-recaptcha\" data-sitekey=\"6LeqjgEsAAAAALTz_wBg5sSbCjhyRf9lduRBupF1\" data-type=\"v3\" data-action=\"Form\" data-badge=\"bottomright\" data-size=\"invisible\"><\/div><\/div>\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"elementor-field-group elementor-column elementor-field-type-submit elementor-col-100 e-form__buttons\">\n\t\t\t\t\t<button class=\"elementor-button elementor-size-sm\" type=\"submit\">\n\t\t\t\t\t\t<span class=\"elementor-button-content-wrapper\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-button-text\">Send<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/button>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/form>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-9c8e03d elementor-widget elementor-widget-text-editor\" data-id=\"9c8e03d\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;ekit_we_effect_on&quot;:&quot;none&quot;}\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>By submitting this form, you confirm you are a U.S. resident and authorize OptiWellness to process this request solely for verification and fulfillment.<br data-start=\"5723\" data-end=\"5726\" \/>See our <span style=\"color: #166b44;\"><strong><a style=\"color: #166b44;\" href=\"https:\/\/optiwellness.net\/privacy-policy\/\">Privacy Policy<\/a><\/strong><\/span>.<br data-start=\"5771\" data-end=\"5774\" \/>This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-0e9e50e e-flex e-con-boxed e-con e-parent\" data-id=\"0e9e50e\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;ekit_has_onepagescroll_dot&quot;:&quot;yes&quot;}\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-8a503ff elementor-widget elementor-widget-html\" data-id=\"8a503ff\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;ekit_we_effect_on&quot;:&quot;none&quot;}\" data-widget_type=\"html.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<script>\r\ndocument.addEventListener('DOMContentLoaded', function() {\r\n  const agentFields = document.querySelectorAll('[name=\"form_fields[authorized_agent]\"]');\r\n  const fieldsToToggle = [\r\n    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'block' : 'none';\r\n    });\r\n  }\r\n\r\n  \/\/ Ocultar al cargar\r\n  toggleAgentFields(false);\r\n\r\n  \/\/ Detectar cambio\r\n  agentFields.forEach(field => {\r\n    field.addEventListener('change', () => {\r\n      \/\/ Si est\u00e1 seleccionado Yes, mostrar; si No, ocultar\r\n      const value = document.querySelector('[name=\"form_fields[authorized_agent]\"]:checked')?.value;\r\n      toggleAgentFields(value === 'Yes');\r\n    });\r\n  });\r\n});\r\n<\/script>\r\n\r\n\r\n<style>\r\n.elementor-field-group {\r\n  transition: all .3s ease;\r\n}\r\n<\/style>\r\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"<p>US State Resident Data Rights Request Form If you are a resident of a U.S. state with a comprehensive consumer privacy law or a law governing the use of consumer health data, you may be able to exercise certain data rights under those state laws. Please complete this form to submit your U.S. State Resident [&hellip;]<\/p>\n","protected":false},"author":17,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"elementor_header_footer","meta":{"footnotes":""},"class_list":["post-1620","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/optiwellness.net\/es\/wp-json\/wp\/v2\/pages\/1620","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/optiwellness.net\/es\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/optiwellness.net\/es\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/optiwellness.net\/es\/wp-json\/wp\/v2\/users\/17"}],"replies":[{"embeddable":true,"href":"https:\/\/optiwellness.net\/es\/wp-json\/wp\/v2\/comments?post=1620"}],"version-history":[{"count":22,"href":"https:\/\/optiwellness.net\/es\/wp-json\/wp\/v2\/pages\/1620\/revisions"}],"predecessor-version":[{"id":1652,"href":"https:\/\/optiwellness.net\/es\/wp-json\/wp\/v2\/pages\/1620\/revisions\/1652"}],"wp:attachment":[{"href":"https:\/\/optiwellness.net\/es\/wp-json\/wp\/v2\/media?parent=1620"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}