I understand that the personal information I provide on this website may be used by Incyte Corporation, or other companies acting on its behalf, to contact me via mail, via telephone, in electronic format, via Internet-based delivery or otherwise in the future. I authorize Incyte Corporation and its agents to contact me via mail, telephone (including leaving a voicemail that mentions opportunities to share my story with Incyte), Internet-based or electronically (e.g., Internet) or otherwise in the future and use and release information about me only for the purposes of (i) providing education and ongoing support services to me related to treatment, disease, and other areas of interest; and (ii) gathering feedback on my therapy treatment and/or disease state. I understand that some of my information may be provided anonymously and used in an individual or aggregated form for other legitimate purposes by Incyte. Neither Incyte Corporation nor anyone working on behalf of Incyte will sell or rent personal information collected on this site. I understand that reasonable efforts will be made to keep my information private even though my information disclosed under this authorization may not be protected under federal and state privacy laws. My personal information may also be used for the purposes described in the Privacy Policy. I understand that from time to time, Incyte Corporation's Privacy Policy may change and that I should check the website for the most recent version. I understand that I should check the website for the most recent version of Incyte Corporation’s Legal Notices.
U.S. State Law Consent to Health Data Use for Marketing Purposes
I consent to Incyte collecting, using and disclosing my health data for the following purposes:
• To conduct marketing activities, including market research activities, and to communicate with me regarding products and services that may be of interest to me.
Incyte uses the following for marketing purposes:
• Health data – my name, gender, date of birth, contact information and information relating to my health condition or treatment.
I understand that Incyte is seeking my consent to collect, use and disclose health data to market products and services to me and I understand that Incyte may use my health data to contact me by email or telephone for the above purposes. I also understand that Incyte will not sell my health data to third parties, but Incyte may disclose my health data to Incyte’s vendors only for Incyte’s business purposes. Finally, I understand that I may withdraw my consent to the use of my health data for marketing purposes by calling 855-446-2983 or visiting www.incyte.com/privacy-policy. I understand that this consent will remain in effect for one year, unless and until I revoke it in writing prior to that time.
By signing the consent, I agree that these entities may use my Health Information to administer the Program or as permitted or required by applicable privacy laws. I permit such use for one year after the dates I sign the consent, unless and until I revoke (i.e., take back) it in writing prior to that time.
By indicating above, I am indicating that I am legally authorized to consent and that I am providing my consent as the patient or the patient’s legal guardian for Incyte to collect, process and disclose my health data I provide for the purposes described within the Consent above.
