By entering this information, I confirm that I am a healthcare professional at least 18 years of age, and that I agree to be contacted. I understand that my phone number and/or email address will be used for this purpose and that my contact information will not be used or shared with third parties (except as may be necessary to fulfill my request to receive updates regarding CARNITOR as well as other medical or product updates). I understand that my consent is not required or a condition of purchasing any products and services. We are collecting personal information in order to fulfill your personal request. Please see Leadiant Biosciences, Inc. Privacy Policy here.

I also understand that to the extent that I have opted-out of communications via the American Medical Association Physician Data Restriction Program, my consent provided here will prevail with respect to the communications described above.