CCPA | UCB California Consumer Privacy Act

This digital system is neither intended nor designed to record or report adverse event information.
For patients/caregivers: If you wish to report an adverse event related to one of our products, please contact your healthcare provider.

First Name

Middle Initial

Last Name

Telephone Number

Mailing Address

City

State

Zip Code

Date of Birth

Your relationship to UCB

NPI Number

DEA

What is your disease relationship?

What right(s) is/are being requested?

The right to be informed

The right of access

The right to delete