By sharing the details, I hereby authorize the service provider and its employees to collect and process my personal information for the purpose of enabling me to participate in Every Heart Counts Patient Support Program. This program is of free service to patients in India who have been prescribed Aztor 10mg or Aztor 20mg, to help manage the disease.

I hereby authorize the service provider to

• Collect personal information from me through WhatsApp number, Link, &/ or telephonically etc
• Provide education on the disease condition, health tips, exercise tips through Web videos, patient education leaflets, SMS etc.
• Follow up with me telephonically or via whatApp for assistance in Every Heart Counts Patient Support Program