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Below, tell us who you are and where you want us to deliver more information about MerckEngage topics and related treatment options.

Merck’s Privacy Commitment
The information you provide will be available to the Merck & Co., Inc. family of companies (collectively, "Merck") and others working on behalf of Merck, to provide the information and services you request. Personal information about you will not otherwise be disclosed for marketing purposes without your permission. Merck reviews personal information and non-identifiable information not only to provide the requested information and services but also to develop and offer additional services and communications that we believe our customers might find of interest. Merck also may use personal information to audit its resources for compliance and security purposes. For more information about how Merck protects personal information about you, please read our Internet Privacy Policy and Privacy Commitment for US Patients, Consumers, and Caregivers.

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By providing your name and other personal information above and clicking the "Submit" button below, you agree to permit Merck and others working on behalf of Merck to use this information to provide you with information, resources, services, and communications about MerckEngage as well as other condition-specific information and related treatment options via e-mail. Additionally, your information may be used for market research purposes. At any time, you can request a copy of this permission and that personal information about you be removed from the Merck contact list for MerckEngage by calling 888-776-8364. Unless you change this selection sooner, your permission will expire 1 year after Merck no longer promotes products related to areas you have elected to receive information regarding. By clicking "Submit," I am signing this form.