‡I agree that I have read
this Consent Form and by providing my personal information and clicking SIGN UP FOR UPDATES I understand and
agree that Mitsubishi Tanabe Pharma America, Inc. (“MTPA”), as well as its collaborators, affiliates, and
agents (third parties working with, or on behalf of, MTPA) (together, the “MTPA Parties”), may use my
personal information to: send me periodic or recurring communications that provide information and/or
materials related to disease state, products, promotions, services, and research studies; ask my opinion
about such information and topics, including performing market research and disease-related surveys; contact
me about other products and services offered by MTPA; share my personal information with one another to
perform these activities; and de-identify it for use in performing research, education, business analytics,
marketing studies, and other commercial products.
I also understand that the MTPA Parties may combine my personal information with
information about me from third parties to better match the communications or materials with my interests.
I understand that my consent or enrollment is not required as a condition of
purchasing any goods or services, including medications, but I won’t be able to receive marketing and/or
promotional communications if I do not consent.
I understand that, depending on the type of contact information I provide, the
MTPA Parties may contact me by mail, email, phone calls, voice messages, interactive voice recordings that
may include use of autodialers or artificial or prerecorded voice messages, and SMS text messages (data
rates may apply).
I understand that I may be contacted by the MTPA Parties in the event I report an
I agree that the MTPA Parties may use my personal information, which includes my
personal health information, to send me periodic or recurring reminders or other information about my
I understand that if I do not want my information used for the purposes described
above, I can discontinue my registration. I also understand that if I register, my consent will be effective
until I opt-out of receiving the relevant marketing communications. Marketing communications will include
information about how I can opt-out of receiving future communications. I understand that my participation
in the Searchlight Support® Program will not be affected if I opt-out.
I confirm that I am the authorized user for the email address and/or phone number
I understand that MTPA will not sell or transfer my personally identifiable
information to any party for the other party’s own marketing use.
By clicking below, I agree to the above terms and conditions.