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Testing is provided by MinuteClinic^®, Everlywell, Inc and Quest Diagnostics Inc and sponsored by Amgen. Subject to terms and conditions. Amgen is not responsible for the testing provider, methodology, or accuracy of results nor is Amgen providing medical advice or entering into a physician–patient relationship with any participants. This is not intended to be a source of medical advice or treatment and does not replace in any way independent medical advice or judgment regarding diagnosis or treatment.

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^†Subject to terms and conditions. Quantities may be limited.

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Patient Authorization and Consent

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Consent to Health Data Processing for What Is My LDL

I consent to Amgen processing my Health Data for the following purposes:

To enroll me and manage my participation in the What Is My LDL program, which includes activities related to my condition or treatment (for example, co-pay card programs, payer medication coverage verification, nurse partner support, disease management support), and to manage Amgen’s products, services, and programs related to my condition or treatment.

Amgen uses the following when it administers the What Is My LDL program:

Health Data – my name (and the name of my caregiver if applicable), gender, date of birth, contact information and information relating to my health condition or treatment.

I understand that my consent to processing is required for me to participate in the What Is My LDL program. I also understand that Amgen will not sell my Health Data to third parties, but Amgen may disclose my Health Data to Amgen’s data processors, contractors, and business partners for Amgen’s business purposes related to the What Is My LDL program. I understand that Amgen may use my Health Data to contact me by mail, email, telephone, or text for the above purposes. I also understand that if I do not consent to the use of my Health Data for the above purposes, I will not be able to participate in the What Is My LDL program. Finally, I understand that I may withdraw my consent to processing my Health Data for the above purposes at any time using one of the methods listed in the Additional Disclosures section below and that if I withdraw my consent, I will no longer be able to participate in the What Is My LDL program.

I consent to the collection, processing, and disclosure of my Health Data for the above purposes I do not consent to the collection, processing, or disclosure of my Health Data for the above purposes By selecting “I do not consent to the collection, processing, or disclosure of my Health Data for the above purposes,” you will not be able to continue enrolling in What Is My LDL By selecting “I do not consent to the collection, processing, or disclosure of my Health Data for the above purposes,” you will not be able to continue enrolling in What Is My LDL

Additional Disclosures

I understand that participation in the What Is My LDL program and, if I have consented, receipt of marketing communications are optional services at no cost to me. The consent(s) above in no way affects my right to obtain any medications and I do not have to provide consent to be able to receive any medications. To obtain a copy of the consent(s) above or to withdraw my consent to collection, processing, and/or disclosure of my Health Data for any of the above purposes to which I have consented, I can contact Amgen by visiting www.amgen.com/DataSubjectRights or calling 1-844-737-2842. For more information about Amgen’s privacy practices, Amgen’s Privacy Statement can be found at www.amgen.com/privacy.

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Terms & Conditions of Testing Programs:

Individuals may use a voucher to redeem a one-time Cholesterol Screening from MinuteClinic^®, one-time Cholesterol and Lipids test from Everlywell, Inc, one-time Cholesterol (Lipid) Panel from a participating Quest Diagnostics Inc. laboratory, as the case may be. The vouchers may only be used by the patient to whom it was given, and in the case of the Quest Diagnostics voucher, for whom it is written, and are nontransferable. The vouchers are not available to individuals below the age of 18 years old and are not intended for professionals. Patients, providers, and labs cannot seek reimbursement for this test from any health insurance or any third party, including state and federally funded programs. These programs are not intended to be a source of medical advice or treatment and do not replace in any way independent medical assessment and advice regarding your diagnosis or treatment. Any questions about diagnosis, treatment or healthcare in general should be presented to your doctor. By participating, you agree that you are solely responsible for determining whether the use of this program is right for you, and you agree to release Amgen Inc. and MinuteClinic, Everlywell, Inc. or Quest Diagnostics Inc. from any liability relating to your participation in the program.

These offers are only valid in the United States and are void where restricted or prohibited by law. These offers are not renewable. Other restrictions may apply. These offers may be limited in quantity and subject to change or discontinuation without notice.

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Terms & Conditions of Testing Programs:

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