Thank you for your interest in making a request under the California Consumer Privacy Act (CCPA) as amended by the California Privacy Rights Act (CPRA). 

Please review the below information prior to submitting a request:

To begin your request, please complete and submit this form. This form collects personal identifiers to verify the identity of the person making the request and to allow us to respond to the personal information request.  Required fields are indicated with an asterisk(*). 

Additional Information

Authorized Agent

Please attach proof that the requester gave you signed permission to submit this request on their behalf. Such proof may be in the form of notarized letter of legal representation, POA or proof of guardianship.

Personnel Information

You must enter the person's information in the form for whom you are making the request. 


If you have any documentation in support of your request, please attach it using the button below. 

We will send an automated acknowledgment of your request. QualTek must verify the identity of the person for whom the request was made.  QualTek can refuse to act on the request if unable to confirm the identity or confirm that the third party has authority to make this request.  It may be necessary for QualTek to make contact for further information to locate the personal data requested if unable to do so from the information provided.  After verifying your identity, we will process your request.