COMPACTCATH CONFIRMATION OF CONSENT

I agree that CompactCath A/S and its affiliates (“CompactCath”) and their third party service providers may collect, use, transfer and process personal and health information about me for the following purposes (“Purposes”):

1. To provide support, guidance, and information about the proper use of CompactCath products;

2. To interact with my healthcare provider, healthcare facility or supplier of product, for prescription verification as necessary, and for supporting receiving the product from a supplier;

3. To conduct consumer and marketing related research and analysis;

4. To provide marketing and educational information related to CompactCath products and services;

5. To process sample requests; and

6. To perform other administrative tasks or to comply with applicable law.

I understand that CompactCath suggests one set of samples per user and may decide at any point to stop the samples program or change its terms without advance notice.

8. I understand that CompactCath may exercise methods to verify sample requests and may refuse users from the samples program if they are unable to be verified or for any other reason.

I agree that CompactCath may contact me by phone (including my cell phone if that is the number I provided), text message (sms), e-mail, hard copy letter, or other means of communication but only for the purposes referred to above. I further understand that I must designate a phone number where I may be reached if I want to be contacted by phone. By designating a phone number and agreeing to the Confirmation of Consent, I provide my consent to receive calls, text messages and/or pre-recorded or artificial voice messages at that number from CompactCath, sent by automated technology. I understand that consent is not necessary to do business with CompactCath.

I understand that I can unsubscribe at any time if I do not want to receive communication from CompactCath other than to receive product samples. I understand that to unsubscribe, I must call CompactCath at 650-468-2661 and receive an unsubscribe confirmation.