In order to participate in the Abbott DBS Ambassador Program (“Program”) as a potential DBS Ambassador I understand that Abbott and/or its service provider will use the information shared above to contact me by phone and may collect health information from me by phone in order to determine if I am eligible to be a DBS Ambassador. Health information is considered to be “sensitive data”. I understand and agree that Abbott and its service provider will use my sensitive data to determine my eligibility to participate in the Program and may share my contact information with potential patients participating in the Program. I agree to the collection and use of my sensitive data by Abbott and its service provider solely for these purposes. Residents of certain states can withdraw by clicking here.

By clicking “Submit”, I have read and understand the Abbott Privacy Policy and agree that the information I have provided above will be used by Abbott and its service provider to contact me by mail, email or phone in order to determine my eligibility to participate in the Abbott DBS Ambassador Program and matching me with potential patients participating in the Program.

In order to participate in the Abbott DBS Ambassador Program (“Program”) I understand that Abbott and/or its service provider will use the information shared above, including my health information (marked with a ^), to contact me by phone and may collect additional health information from me by phone in order to determine if I am eligible to be matched with a DBS Ambassador. Health information is considered to be “sensitive data”. I understand and agree that Abbott and its service provider will use my sensitive data to determine my eligibility to participate in the Program and may share my contact information with a DBS Ambassador. I agree to the collection and use of my sensitive data by Abbott and its service provider solely for these purposes. Residents of certain states can withdraw by clicking here.

By clicking “Submit”, I acknowledge that I have read and understand the Abbott Privacy Policy as well as Abbott’s Consumer Health Data Policy and agree that the information I have provided above will be used by Abbott and its service provider to contact me by mail, email or phone in order to determine my eligibility to participate in the Abbott DBS Ambassador Program and matching me with a DBS Ambassador.