Opt In Form | CSL Vifor

Consent form for Healthcare Professionals

If you, as an HCP, wish to receive electronic promotional and non-promotional information from CSL Vifor, please subscribe using this form.

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National HCP number (if applicable)

Hospital details

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Communication preferences

Select the channels through which you agree to receive the communications and specify the corresponding contact details:

(Please select at least one option)

SMS

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Please confirm that you have read Vifor Pharma Group's privacy notice

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Математичне завдання 6 + 12 =

Розв’яжіть цей простий математичний приклад і введіть відповідь. Наприклад, для 1+3 введіть 4.

I hereby consent to receive communications from the CSL Group, including promotional and non-promotional information, through the channels I have selected above, as specified in the Privacy Notice

CONSENT FORM FOR HCPS

Consent form for Healthcare Professionals

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CONSENT FORM FOR HCPS

Consent form for Healthcare Professionals

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