Consent to Process Personal Information, Including Personal Health Information
As described in our Privacy Notice, when contacting Reata about medical inquiries, we require your explicit consent to process your personal information, including personal health information, which will be used by Reata to communicate with you and with third parties in the context of clinical trials. You have the right to withdraw your consent at any time without negative consequence. Upon your request for deletion, your data will be deleted from our files and the third parties’ clinical trial files.
Please tick to mark your consent and agreement:
Yes, I agree to have my personal information, including personal health information, used to communicate with me.
Yes, additionally, I agree that Reata may share my personal information, including personal health information, with third parties in the context of relevant clinical trials or as otherwise set forth in our Privacy Notice.
Yes, additionally, I agree that Reata may use my personal information to keep me informed about Reata’s trials or other activities Reata believes may be of interest to me.
*RA European Economic Area data subject is deemed not to have agreed to the language in this box as Reata has a legitimate interest to process the data of such subject in order to respond to the subject’s request or inquiry.
To see if you may qualify for participation in FALCON, please answer the following questions to the best of your ability. This should take approximately 5 minutes. The information you provide will be used ONLY for the purpose of determining your potential eligibility for the study.
1. Are you between the ages of 18 and 70 years old?
Web Ads or Google Searches
Facebook or other social media
National Kidney Foundation
Other, please specify
14. Please provide your contact information so we can reach out if you qualify for in-person screening visits. As a reminder, your information will not be used for other purposes.