TITLE Subtitle including date and time RM_StatsI want to attend the meeting: * Face to face Virtually Food preference (if face to face) Gluten free Dairy free Vegetarian Pescatarian Vegan Nut free No fish No shellfish No pork No celery First name *Last name *Title *Email *Work place (clinic, hospital, etc.) *Address (work) *Postal code and city *In the meeting we will share a participants list with names, workplace and work emails. I wish to be removed from the list Astellas Pharma may send you further information about this event via email. Astellas Pharma Nordic *), will process as data controller the personal information stated above in order to document your attendance at this event. We respect your right to privacy. You can read more about how we use your personal information, and how you can exercise your privacy rights, in our Event Privacy Notice *) For the purpose of this attendee list, “Astellas Pharma Nordic” shall mean Astellas Pharma a/s (Denmark), Astellas Pharma AB (Sweden), Astellas Pharma (Norway) and Astellas Pharma A/S, filial in Finland (Finland). Do you want to receive healthcare, medical and scientific-related materials from Astellas Pharma in the future? Consent I hereby consent that Astellas Pharma Nordic*) can use the personal details I have provided for the purpose of sending me healthcare, medical and scientific-related information and materials, including invitations** for Astellas events and activities by email, which Astellas believes may be of value to me, relevant to my work or tailored to my professional profile and may be promotional in nature. IMPORTANT: Your consent is voluntary and you can withdraw it at any time by clicking the “unsubscribe” link in any email communication you receive from Astellas going forward, or alternatively by sending an email to privacy@astellas.com Astellas is committed to protecting your personal information and will only use it in accordance with the applicable data privacy law and our Astellas Privacy Notice. For further information on how we process and protect your personal information and how you may exercise your data protection rights, please refer to our Privacy Notice at https://policy.astellas.dk/en-general-privacy-notice/ If you have any questions or concerns, please contact us at privacy@astellas.com. *) For the purpose of this consent, “Astellas Pharma Nordic” shall mean Astellas Pharma a/s (Denmark), Astellas Pharma AB (Sweden), Astellas Pharma (Norway) and Astellas Pharma A/S, filial in Finland (Finland). ** Astellas complies with the current Lif agreements with the Danish Regions and will not send any invitations directly to any hospital-employed HCPs where not allowed. Some days before the meeting you will receive an email with the link to connect to the online meeting. Note: It looks like JavaScript is disabled in your browser. Some elements of this form may require JavaScript to work properly. If you have trouble submitting the form, try enabling JavaScript momentarily and resubmit. JavaScript settings are usually found in Browser Settings or Browser Developer menu. MAT-NC-NON-2022-00007