CCPA Notice at Collection - Template

This is a free template PracticPro customers can use on their own intake forms (contact forms, lead forms, booking forms) to help satisfy the "notice at collection" requirement under the California Consumer Privacy Act (CCPA) and the California Privacy Rights Act (CPRA).

What is "notice at collection"? California law requires any business that collects personal information from a California resident to notify them - at or before the moment of collection - of what categories of personal information are being collected and the purposes for which it will be used. The notice has to be easy to find. Hiding it three clicks deep in a privacy policy is not enough.

1. Short version (most intake forms)

Paste this near or below your form submit button. It is short on purpose - just enough to meet the law for a typical contact or lead form.

By submitting this form you authorize us to collect the personal information you provide (such as your name, contact details, and any project details) for the purpose of responding to your inquiry, providing our services, and contacting you about your project. We do not sell your personal information. See our [Privacy Policy](#) for full details and your rights under California law.

Replace [Privacy Policy](#) with a real link to your privacy policy.

2. HTML version (for websites)

Same content as above, formatted as HTML you can paste into a page editor or directly into your form template.

<p style="font-size:12px;color:#555;margin-top:8px;"> By submitting this form you authorize us to collect the personal information you provide (such as your name, contact details, and any project details) for the purpose of responding to your inquiry, providing our services, and contacting you about your project. We do not sell your personal information. See our <a href="/privacy">Privacy Policy</a> for full details and your rights under California law. </p>

Replace /privacy with the URL of your own privacy policy.

3. Longer version (when you collect more than basic contact info)

Use this if your form collects sensitive categories of data (financial information, precise geolocation, health-related details, government IDs, etc.).

When you submit this form, we collect the following categories of personal information: - Identifiers (name, email, phone number, address) - Commercial information (services requested, payment details if applicable) - Internet activity (IP address, browser information) - Inferences drawn from the above (project preferences, service needs) We use this information to: (a) respond to your inquiry, (b) provide and improve our services, (c) communicate with you about your project, and (d) meet legal obligations. We do not sell or share your personal information for cross-context behavioral advertising. California residents have the right to know what personal information we hold, to request correction or deletion, and to opt out of certain processing. See our [Privacy Policy](#) for the full list of rights and how to exercise them. Information is retained as described in that policy.

How to use the template

  1. Pick the version that best fits your form (most businesses use #1 short version).
  2. Paste it near the submit button on the form, or directly under the last field. It must be visible at the moment the user submits.
  3. Replace the privacy policy link with a real URL pointing to your own privacy policy.
  4. If your form collects categories of data not listed above (for example, biometric data, precise GPS, government IDs), add them to the list and describe how they are used.

What this template does NOT cover

  • A full privacy policy. You still need a privacy policy on your website. The notice at collection complements the policy; it does not replace it.
  • Opt-out of sale / share links. If you sell personal information or share it for cross-context behavioral advertising, you also need a "Do Not Sell or Share My Personal Information" link. Most service providers do not do this and don't need the link.
  • Sensitive personal information notices. If you specifically collect sensitive PI (Social Security Numbers, precise geolocation, contents of mail/email, biometric data, etc.), there are additional disclosure obligations. Consult counsel.
  • Special categories under other laws. HIPAA-covered health data, financial data under GLBA, and data of children under COPPA have their own rules and are not handled by this template.
Not legal advice. This template is a starting point that reflects common CCPA / CPRA practice for service businesses. Privacy law evolves. If your business handles sensitive data, operates in multiple regulated jurisdictions, or is at significant risk in the event of a complaint, have qualified counsel review your full notice-at-collection and privacy policy. PracticPro provides this template without warranty of any kind.

Questions about this template: email [email protected].

Last updated: May 24, 2026