Submit a Claim - Claim Instructions

This Claim Form should be filled out online or submitted by mail if you had either documented losses fairly traceable to the Data Incident or you wish to receive an alternative cash payment. Checks will be mailed, or electronic payments will be made, to eligible Settlement Class Members if the Settlement is approved by the Court.

Complete information about the Settlement and Settlement Benefits are available in the Notice and on the Frequently Asked Questions (FAQs) page of this website.

Claim Forms must be submitted online or postmarked (if mailed) no later than June 18, 2026. Claims submitted after the deadline will be deemed untimely and may not be accepted.


Documentation:

If you are filing online, please have this information ready before you start to file, as your Claim will not be saved if you must come back and finish at a later time. Uploaded documents must be less than 20 MB per file and in one of these formats: jpg, jpeg, png, gif, tif, tiff, doc, docx, xls, xlsx, pdf, txt, rtf, or zip. If you are unable to electronically upload a copy of your documents as part of the online Claim Form, you will need to mail a printed Claim Form along with your documentation to the Settlement Administrator.


File Online:

Before Claim Filing:

Unique ID and PIN required for online Claim Form submission: You will need the Unique ID and PIN printed on the Postcard Notice that you received in the mail. If you did not receive a Postcard Notice or have lost yours, please contact the Settlement Administrator at info@AbsoluteDataSettlement.com or 1-877-239-0776 for assistance.

During Claim Filing:

Specific Claims Made: As part of filling out your Claim Form, you will be asked to verify your personal information and any specific claims you are asserting. Settlement Class Members may submit a Claim Form for reimbursement of Documented Loss up to a total of $5,000.00 per claimant, and/or Settlement Class Members may submit a Claim Form for an Alternative Cash Benefit. Cash Payments will be distributed on a pro rata basis, which will be determined by the number of valid and timely Claims.

You must also submit all required supporting documentation such as receipts for fees paid and descriptions. Supporting documentation should be clear, readable copies, as they will not be returned to you. Please keep copies of everything you submit, as your claim may be audited, and you could be asked to provide additional information to process the claim.

After Claim Filing:

Confirmation Code: After submitting your completed claim online, you will receive an email with a confirmation code for your completed submission. Be sure to keep your confirmation email and code and refer to them if you have any questions about your Claim Form.

Please use the login below to get started.


Submit a Claim Form - Login
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File by Mail:

If you wish to submit a Claim Form via standard mail, you may download a copy of the Claim Form here. You will need to provide all the information requested on the Claim Form (remembering to sign and date it), attach any supporting documentation, and then mail it to the following address:

Absolute Dental Data Incident
Settlement Administrator
P.O. Box 2973
Portland, OR 97208-2973

Remember: All Claim Forms must be submitted online or postmarked no later than June 18, 2026.