Harvest Opt-Out Form

Participant ID:

(5 digits)

Site Name:

Database:

Name:

Email:

Confirm Email:

Phone:

What harvest are you wishing to Opt-Out of?

On behalf of the Participant ID listed above, I am electing to opt-out of the harvest period referenced in the previous section. By opting out, I acknowledge that the Participant ID listed above will not be included in the data analysis and will not receive risk-adjusted results for the corresponding harvest period.