Bayer Registration

Please complete the following fields to register for Health Loyalty and receive your login credentials.

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I am a ...

Are you an inserting HCP

Inserting HCP?

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I understand that Bayer Inc. (''Bayer'') and its affiliates, and Health Loyalty® as program administrator on behalf of Bayer, obtain my personal information on this form for purposes of administering the Bayer IUS Replacement Program/Care for Contraceptive Choices, including monitoring and optimizing these and other Bayer programs and for program research and evaluation. I also understand that Bayer is required to report adverse drug events to regulators and that my information may be disclosed for this purpose. I understand that my information may be transferred outside of my province and/or Canada and accessible to law enforcement or other authorities. Information on Bayer’s privacy practices including privacy rights may be accessed at: https://www.bayer.ca/en/privacy-statement/. I am a licensed Canadian Healthcare Professional authorized to prescribe IUS. I understand that Bayer funds this program and I will make my patient aware of this funding. I agree to be contacted by Health Loyalty® or Bayer for the purposes of administration of the IUS Replacement Program/Care for Contraceptive Choices. I certify that all information provided in this form is true and accurate. I understand and acknowledge that submission of false information may result in permanent denial or revocation of access to the Bayer IUS Replacement Program/Care for Contraceptive Choices.

IUS Replacement / Care for Contraceptive Choices

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