Register now and be part of Hepatitis Free Malaysia’s “How’s Your Blood?” a nationwide awareness campaign to increase Hepatitis C awareness and educate the public about the importance of screening.

Your support and commitment make the difference in our search for the missing thousands with Hepatitis C in Malaysia.

I agree to participate in “How’s Your Blood?” (campaign) with Hepatitis Free Malaysia and hereby authorize Hepatitis Free Malaysia to use my name, and other details whether it be for print, broadcast or electronic media including, radio and television broadcasting and exhibition for this campaign purposes.

In case if I am providing any incorrect information or concealing/withholding any information from Hepatitis Free Malaysia, including without limitation incorrect declaration of Information relating to this campaign, shall entitle Hepatitis Free Malaysia to disqualify my participation without any further intimation .

I understand that I will receive no monetary compensation for the rights granted herein. I understand that all ownership rights belong to Hepatitis Free Malaysia.

If by reason of my statements and actions on this campaign or materials furnished by me for the campaign, there is any claim or litigation involving any charge by third parties of violation or infringement of their rights, I agree to indemnify and hold harmless Hepatitis Free Malaysia from any liability, loss or expenses arising from such claim or litigation.

Hepatitis Free Malaysia shall not be responsible for any claims arising out of any failure(s) which is beyond the reasonable control of Hepatitis Free Malaysia. Without limiting the generality of the foregoing, Hepatitis Free Malaysia shall not be responsible for any claims arising out of technical failures before, during or after the completion of the campaign.

Hepatitis Free Malaysia reserve the right to extend, cancel, discontinue, prematurely withdraw, change, alter or modify this Campaign or any part thereof including the eligibility criteria, the Terms and Conditions and gratification at their sole discretion at any time Hepatitis Free Malaysia may use subcontractors or third party vendors to execute certain tasks associated with this campaign and its duration.

I hereby confirm that I am a certified doctor or Healthcare Professional (HCP) under the Ministry of Health (MoH) in Malaysia.

By submitting this Form, you hereby agree that Hepatitis Free Malaysia may collect, obtain, store and process your personal data that you provide in this form for the purpose of receiving updates, news, promotional and marketing mails or materials from Hepatitis Free Malaysia.

You hereby give your consent to Hepatitis Free Malaysia to:-

Store and process your Personal Data;

Disclose your Personal Data to the relevant governmental authorities or third parties where required by law or for legal purposes.

In addition, your personal data may be transferred to any company within the Hepatitis Free Malaysia which may involve sending your data to a location outside Malaysia. For the purpose of updating or correcting such data, you may at any time apply to the Hepatitis Free Malaysia to have access to your personal data, which are stored by Hepatitis Free Malaysia.

For the avoidance of doubt, Personal Data includes all data defined within the Personal Data Protection Act 2010 including all data you had disclosed to Hepatitis Free Malaysia in this Form.