By submitting this form, I acknowledge all information I provided may be used by Sanofi US, its collaborators, affiliates and contracted service providers (collectively "Sanofi") to provide me with additional information about products or services.
Once my health information has been disclosed to Sanofi, I understand that federal privacy laws may not protect it from further disclosure. However, Sanofi agrees to protect my health information by using and disclosing it only for the purposes allowed by me in this authorization or as otherwise allowed by law, and will not sell or rent my information to any unauthorized parties or mailing lists.
I authorize Sanofi to contact me by mail, telephone, or email with information about atopic dermatitis and products, promotions, services and research studies, and to ask my opinion about such information and topics, including market research and disease-related surveys.
I further authorize Sanofi to de-identify my health information and use it in performing research, education, business analytics, marketing studies or for other commercial purposes. I understand that different Sanofi parties may share identifiable health information with one another in order to de-identify it for these purposes and as needed to perform the Services or to send the communications listed above (the "Communications").
I understand that I do not have to provide this information or receive the Communications, and that doing so will not affect my medical treatment, or access to health benefits or Sanofi medications. I may opt out of receiving Communications at any time by notifying a representative by telephone at 800-633-1610 or by sending a letter to Sanofi US Customer Services, P.O. Box 5925 Mailstop 55A-220A, Bridgewater, NJ 08807.
Questions or comments? Contact Sanofi US or call 1-844-643-7346 to contact Regeneron Pharmaceuticals, Inc.
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