coflexConnectSM Consent Agreement
By completing and submitting this form, I acknowledge that I am a US resident over the age of 18; and I authorize Legacy Health Strategies (“Legacy”) to enter the information I have provided into a database solely for purposes of receiving personalized education and support from Legacy. I agree that Legacy, its agents, subcontractors, affiliates, or third parties under contract with them may contact me from time to time by telephone or email to provide information about services related to coflexConnectSM. I understand that the information will be treated confidentially and will be accessed only by authorized personnel or third parties under contract with Legacy or its affiliates. I have a right of access and verification to my personal information. I also have a right to opt-out of receiving information at any time. Subject to the above, unless authorized by me, my personal information will not be sold or transferred to third parties, other than in the event of Legacy or its affiliates being sold. This consent shall be valid and enforceable until such time as I opt out. If I no longer wish to receive information, I may opt-out at any time by calling my assigned coflexConnectSM Coordinator or by clicking “Unsubscribe” on any Program email. This statement may be updated from time to time.