Individual Privacy Rights Request Self-Service Form

To unsubscribe from Communication from ViiV please select from the three options (HCP, Patient, or Consumer) below. Otherwise, proceed with submitting an individual rights request further below. 


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You have reached the ViiV Healthcare individual privacy rights request form. ViiV partners with OneTrust to communicate with you about your individual privacy rights requests. Please complete the form below. Your request will be reviewed and a response will be provided using the communication channel of your choice. Please note that correspondences you may receive will come from GSK on behalf of ViiV Healthcare.

Myself
For Someone Else

To ensure we are able to initiate your request, please complete your (or the individual's) specific information below.

Enter the first name of the data subject
Enter the last name of the data subject
Please enter your permanent mailing address
Enter country of residence.
Please select a state
If we need additional information to process your request, how would you like to be contacted?
Email
Mailing Address
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. Please use the attachment feature below to provide this information