REGISTRATION

If you are interested in participating in the studies as an investigator and want to know more about the Selatogrel Outcome Study in suspected Acute Myocardial Infarction (SOS-AMI) clinical program, please provide your contact details with consent for a clinical expert from Viatris Inc., its aﬃliates and subsidiaries, to contact you. We assure you that we will use the information collected for non-promotional purposes only.

I am interested to know more about the SOS-AMI Clinical Program. I hereby give my consent for a clinical expert from Viatris Inc., its affiliates and subsidiaries, to contact me to provide further details. I conﬁrm that I am a registered healthcare professional.

Full Name:

Email (please complete if you wish to be contacted by email):

Telephone No. (with country code) (please complete if you wish to be contacted by phone):

Affiliated Hospital/ Institution:

I agree to be contacted by VIATRIS, Inc and its affiliates by telephone regarding the SOS-AMI Clinical Program at the phone number specified above*

I hereby consent to be contacted by VIATRIS, Inc. and its affiliates via email for the purpose and at the email address indicated above regarding the SOS-AMI Clinical Program*

Signature

*PRIVACY NOTICE
I understand and acknowledge that all personal data processed by Viatris is handled in accordance with local privacy laws and, where permissible, may be processed in countries outside of the jurisdiction in which it was collected. I understand that my consent is voluntary, and I can withdraw my consent at any time. The withdrawal of consent will not affect the lawfulness of processing based on consent before its withdrawal. I acknowledge that I am not obliged to provide my personal data. However, if I do not provide the information, I may not be able to participate fully in activities managed by Viatris for the purpose set forth above. I confirm that the information I have provided above is correct, and I agree to Viatris’ processing of your personal data, including its transfer, where permissible, internationally and to third parties, in accordance with the Viatris Privacy Notice at www.viatris.com/en/privacy-policy in with privacy laws. I understand that, as a data subject, at any time, in accordance with the applicable laws and regulations regarding the protection of personal data and subject to the conditions set out therein, I may exercise my rights of access, rectification, cancellation, limitation of the processing of my personal data, as well as the right to receive my personal data in a structured format, commonly used and readable by automatic device. I also acknowledge that I have the right to withdraw my consent at any time. To exercise your rights, or for any request relating to the processing of your personal data, please contact us at the following address: Privacy Office Officer: dataprivacy@viatris.com.

Selatogrel is an investigational drug currently undergoing Phase 3 clinical trials. It has not been approved for use in any country

Viatris, Robert J. Coury Global Center, 1000 Mylan Blvd., Canonsburg, Pennsylvania 15317, United States

Data Processing ...