Participation in the CINRYZEConnect Program is completely voluntary, such that no compensation, reimbursement, or other consideration is provided by ViroPharma for participation.
ViroPharma has created the CINRYZEConnect Program for people living with hereditary angioedema (HAE), enabling them to communicate with one another and share their experiences. ViroPharma makes the initial contact possible, but after the introduction ViroPharma has no involvement with conversations between mentors and mentees.
Mentors in this program are not trained by ViroPharma. All participants acknowledge that mentors are not representatives of ViroPharma, nor do they speak on behalf of ViroPharma.
Mentors are not physicians or medical experts. Mentors are people who have been prescribed CINRYZE® (C1 esterase inhibitor [human]). CINRYZE is an injectable medicine that is used to help prevent swelling and/or painful attacks in teenagers and adults with HAE. Though mentors may answer questions about living with HAE, they are not qualified to give medical advice.
All conversations are between mentors and mentees. ViroPharma would hope these conversations remain confidential. However, due to ViroPharma’s limited involvement of only making initial contact possible, ViroPharma does not and cannot guarantee such confidentiality. Conversations will not be tracked or recorded by ViroPharma. Conversation topics are decided by the mentor and mentee.
By selecting "Agree" to this Participation Agreement and then electronically signing and submitting the Authorization Form, I elect to participate in the CINRYZEConnect Program. I acknowledge that my participation in this program is completely voluntary. In addition, I acknowledge that, as a participant in the program, I am providing ViroPharma Incorporated ("ViroPharma") with certain personal medical information, which includes among other things (i) my name, (ii) my mailing and email address, (iii) my date of birth, (iv) whether I have been diagnosed with hereditary angioedema ("HAE"), and (v) which (if any) medications I am taking to treat HAE (optional).
ViroPharma is committed to maintaining the privacy and security of personal information and will protect the information that you provide pursuant to this authorization in accordance with its policies and procedures.
CINRYZE® (C1 esterase inhibitor [human]) is an injectable medicine that is used to help prevent swelling and/or painful attacks in teenagers and adults with Hereditary Angioedema (HAE).
Important Risk Information
You should not use CINRYZE if you have had life-threatening immediate hypersensitivity reactions, including anaphylaxis to the product.
I authorize ViroPharma and its partners to contact me, assign a mentor for me, and provide me with the mentor’s contact information. I authorize ViroPharma to use my medical information to send me promotional materials related to CINRYZE® (C1 esterase inhibitor [human]) and the CINRYZESolutions® Programs.
I understand that I may cancel this authorization at any time by mailing a letter requesting such cancellation to ViroPharma Incorporated, 730 Stockton Drive, Exton, PA 19341, but that this cancellation will not apply to any information already used or disclosed through this authorization.
Upon selecting "Agree" you will be taken to the Authorization Form to complete the sign-up process.