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URL: https://www.jazzpharma.com/privacy-statement/
Submission: On April 12 via manual from US — Scanned from DE

Form analysis 2 forms found in the DOM

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            <p>By clicking “Submit” above you represent that you are a resident of the State of California as defined in Section 17014 of Title 18 of the California Code of Regulations</p>
            <p>Jazz Pharmaceuticals, Inc. 3170 Porter Dr., Palo Alto, California 94304</p>
            <p><a href="https://www.jazzpharma.com/privacy-statement/" target="_blank">https://www.jazzpharma.com/privacy-statement/</a></p>
            <p>For further information please contact Jazz Pharmaceuticals’ Privacy Office at <a href="mailto:privacy@jazzpharma.com">privacy@jazzpharma.com</a> </p>
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PRIVACY REQUEST FORM

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Please select and enter the required fields on the form below. We need this
information to process your request and to take necessary steps to verify your
identity.

We will contact you if we need any additional information

I am making this request for myself or on behalf of someone else *
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On behalf of someone else
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Access Data
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Other - please select if applicable
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Select Jazz Pharmaceuticals Product(s)*
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Product 2
Product 3
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Last Name *
Date of Birth *
Email address * Please use the email address you have previously provided to
Jazz Pharmaceuticals
Phone *
Address *
City *
State *
ZIP *
Country *
SUBMIT

By clicking “Submit” above you represent that you are a resident of the State of
California as defined in Section 17014 of Title 18 of the California Code of
Regulations

Jazz Pharmaceuticals, Inc. 3170 Porter Dr., Palo Alto, California 94304

https://www.jazzpharma.com/privacy-statement/

For further information please contact Jazz Pharmaceuticals’ Privacy Office at
privacy@jazzpharma.com







Thank you for contacting Jazz Pharmaceuticals Corporate Development & Partnering















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CONTACT CORPORATE DEVELOPMENT / PARTNERING

Personal Information (All fields are required)
Please provide details on this opportunity
First Name:
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Zip Code:
Country:
Phone Number:
Email Address:
Therapeutic Area:
Indication:
Mechanism of Action:
Highest Development Phase:
Overview of Opportunity
including non-confidential information supporting the rationale for the
molecular target, proof-of-concept for a particular technology and other
relevant details.
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