User Data Deletion Request

If you want to have your personal data removed from our systems and databases, please complete the form below. By submitting this form, you are providing the necessary information to help us identify your account across our apps and web platforms. Once submitted, we will process your request promptly and ensure your data is deleted as requested.

The form below addresses the removal of data from the following apps and services:

App: myAxonics^TM App
Website: Axonics.com

To proceed, please fill out the form below to begin the data deletion process.

* Indicates required fields

Full Name *

Email Address *

Confirm Email Address *

Username (if applicable)

Account ID/User ID (if applicable)

Phone Number

Request Type *

Specific Data to Delete (if selected)

Reason for Deletion (Optional)

Data Deletion Consent * I confirm that I am providing the above information solely for the purpose of identifying my account within your systems and databases across all apps and web platforms associated with this request. I also confirm that I want to permanently delete my personal data and understand that this action cannot be undone.

Additional Comments or Requests (Optional)