We’d love to hear about your weight loss journey
First Name
*
Last Name
*
Email Address
*
Contact Number
*
Your Story
*
Max of 850 characters
Johnson & Johnson Medical Pty Ltd (JJM) operates the weight loss surgery website (Website). The Website provides access to information regarding weight loss (bariatric) surgery, including a collection of real Australian weight loss surgery stories (Stories).
By submitting this form, the person named in this form wishes to be included in the Stories. By providing the details in this form, and by submitting this information, the person agrees to allow JJM to use personal information (excluding the above contact information) for the purposes of including the patient experience in the Stories.
The personal data collected on this form will be used to process and manage our relationship with you, and to contact you in relation to our Stories campaign. Your personal information may also be processed by our contracted service providers who assist us with database management activities. Those service providers may be located overseas, including in France and the USA, and are subject to contractual measures to safeguard and protect your personal information consistent with Australian privacy laws. For information about how you can request access to or correct your personal information, make a privacy enquiry or complaint, or to see our full Privacy Policy, please go to
https://www.jnjmedtech.com/en-AU/policies-privacy
ADVERSE EVENT OR PRODUCT COMPLAINT
If your feedback pertains to an adverse event or a product complaint, contact:
productsafetyjjmanz@its.jnj.com
who will forward the information to Product Safety Department and comply with local policies for notification.
By submitting this form, I acknowledge that I've reviewed and agree to the website's
Privacy Policy
.
213162-220511. May 2022.
