Patient Authorization
I authorize Amgen and its contractors and business partners (
Amgen ) to use and/or disclose my personal information,
including my personal health information, for the following
purposes: to operate, administer, enroll me in and/or continue
my participation in Amgen s text based digital migraine
tracker and related activities; to provide me with
informational and promotional materials relating to Amgen
products and services, and/or my condition or treatment;
and/or to improve, develop, and evaluate products, services,
materials and programs related to my condition or treatment.
I consent to Amgen contacting me about the text based digital
migraine tracker using the information provided in this form.
Amgen may contact me using an automatic dialing machine,
prerecorded voice or SMS/text message (standard text messaging
rates may apply).
Reply STOP to cancel messages.
I further understand that the text based digital migraine
tracker and additional informational and marketing
communications related to my condition and treatment are
optional and free services. I do not have to sign this
authorization and this authorization in no way affects my
right to obtain any medications. For further information about
Amgen s privacy practices please see
https://wwwext.amgen.com/privacy-statement and for terms of use, please see https://wwwext.amgen.com/terms-of-use.
By clicking "Submit" I agree to enroll in the text
based digital migraine tracker, and to receive marketing
communications from Amgen. I can opt-out at any time.
Program Details
To join Aimovig's Migraine program go to
www.aimovig.com/migrainetracker
or call 1-833 246 6844 to register. Fill in the required
information including your mobile number and email address.
You will receive an opt-in request from the short code. After
you reply with the keyword START you will receive a
confirmation message and be opted into the program.
You will receive recurring questions and alerts. Reply HELP to
43109 for help, STOP to 43109 to cancel. Message and Data
Rates May Apply.
TO OPT-IN TO THE SERVICE ON 43109:
Fill out the registration form at
www.aimovig.com/migrainetracker. Reply START to the message
you receive.
RESPONSE FROM 43109:
Thanks! You'll start receiving daily texts tomorrow. Msg&Data
rates may apply. Reply HELP for help. Reply STOP to cancel.
To STOP (OPT-OUT OF) THE SERVICE ON 43109:
You can cancel receipt of all SMS messages from 43109 by
replying to any service message, or sending STOP to 43109.
STOP RESPONSE:
Thanks for tracking. You ll no longer receive texts for your
migraine tracker.
TO GET HELP ON THE SERVICE ON 43109:
You can get HELP, by replying to any service message, or
sending HELP to 43109.
HELP RESPONSE:
Questions about your migraine tracker? Call 833 246 6844.
Reply MMD at any time for the migraine day definition. Reply
STOP to cancel.