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In addition to the below consent, I understand that by checking this box and by checking “I accept” [below], I consent to Amgen calling and texting me at the phone number(s) I have provided with promotional communications relating to Amgen products and services and/or my condition or treatment.Amgen may use automatic dialing machines or artificial or prerecorded messages to contact me and may leave a voicemail or SMS/text message (standard text messaging rates may apply).I understand that Amgen, as well as Health Care Providers, cannot require me, as a condition of having access to medications, prescription drugs, treatment or other care, to sign this Authorization.

Zalecamy, aby wszyscy użytkownicy zdecydowali się na wersję Flash czatu (obecnie używaną).

Tylko użytkownicy premium mogą oglądać kamerki innych użytkowników.

I understand that I am not required to provide this consent as a condition of purchasing any goods or services.

Amgen’s Privacy Notice and Patient Authorization Uses and Disclosure of Personal Information I authorize Amgen and its contractors and business partners (“Amgen”) to use and/or disclose my personal information, including my personal health information, only for the following purposes: In order for Amgen to provide me with the services and/or programs described above, Amgen needs to collect and use my personal information, including my personal health information.

I understand that I can obtain a copy of this Authorization or cancel this Authorization at any time by calling Amgen at 1-888-4ENBREL (1-888-436-2735) or by writing to PO Box 7249, Bedminster, NJ 07921.

If I cancel my consent, I will no longer qualify for the services described.

I also understand I am authorizing my personal information, including my personal health information, to be used for the purposes described above.

I understand and agree that by signing below, I am authorizing those who rely on this Authorization to release my personal health information for the earlier of five (5) years or until my participation in the program ends through my cancellation, unless a shorter time period is required by state law.

I also understand that if a Health Care Provider is disclosing my personal health information to Amgen on an authorized on-going basis, my cancellation with Amgen will be effective with respect to any such Health Care Providers as soon as they receive notice of my cancellation.

No Effect on Treatment I understand I do not have to sign this Authorization and that my enrollment in any of the services and/or programs described above is entirely voluntary.

Aby korzystać z pełnych funkcji serwisu, musisz pozwolić na przeglądanie zawartości Flash w przeglądarce.

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