First Name ^*

Last Name ^*

Second Name (control) ^*

Email ^*

Mobile/Telephone (optional)

Profession ^*

Practice Name ^*

Practice Address ^*

Postcode ^*

(* Mandatory)

I acknowledge that by registering to join the HCP Network:

I authorize Teva Pharma Australia Pty Ltd (Teva), its affiliates and service providers to contact me by mail, email, telephone, and electronic message for communication about Teva’s business, products, services, events and to conduct market research.

Our service providers and affiliates are based in jurisdictions including Australia, Israel, United States, and the European Union and handle your information according to their local laws, which may not ensure compliance with Australian law. By making this acknowledgement you consent to the disclosure of your information on this basis, including that Teva will be accountable according to local laws and not under the Australian Privacy Act and that you may seek redress according to your local laws and not the Australian Privacy Act 1988 (Cth) in respect of such practices.

I have read and accept the terms of use and privacy policy

I confirm that I am a healthcare professional