Data Subject Right Requests

Please use this form if you wish to submit a request related to personal information held by Biogen in accordance with your privacy rights under applicable data protection law. By submitting this request form you acknowledge that the information you provide is accurate and that you have authorization (if submitting on behalf of another individual). You further authorize Biogen to process the below information in order to complete your request.

To learn more about your privacy rights and how to exercise them, visit our Privacy Center.

This form is only applicable to residents of the United States. Depending on the state of residency, you may have one or more of the rights listed below. Please be aware that these rights may be limited or not available under the privacy laws of your state of residency. Please see our US Privacy Policy for more information.

* Denotes required field

What's your relationship to Biogen*

If other, please speficy

What is your state or territory of residency?*

What type of request are you making (select one)*

Your Personal Information

Email address (required)*

First name*

Last name*

Address type

Street address

Apartment or unit

Zip code

City

State

Phone type*

Phone number*

Email provided to Biogen if different from email provided above

Additional details related to Biogen programs and/or mobile application(s) with which personal information was provided:

Email privacy@biogen.com if you have any questions or technical issues with this form.

If you are submitting this request on behalf of someone else (i.e., as an Authorized Agent), then you are required to provide written proof of this authorization. After submitting this form, please email proof of authorization as an attachment to privacy@biogen.com. Include in the subject line of the email, the first and last name of the data subject.

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Data Subject Right Requests

Your Personal Information