Secondarycare consent capture

First Name *

Surname *

Work e-mail address *

Organisation/Hospital *

Postcode *

Telephone number

What area is of interest to you? Please select all that apply

Multiple Sclerosis

Headache

General Pain

Other

Please tick the box if you are happy for Teva UK and its affiliates to contact you with promotional information about Teva events, products and services. As part of this, we use information such as the Teva emails you read, the Teva web pages you visited, and the Teva-organised or Teva-sponsored events you attended, to ensure they stay relevant for professionals like you. All of this is described in our privacy notice, which also explains how you can change your preferences.