SIGN UP
FOR MORE INFORMATION

Personalized support throughout your treatment

By signing up, you’ll get access to information all about LEQEMBI—from your first infusion
to ongoing treatment. Plus, useful tips to help ensure you’re always in the know.

Note: Extra questions may appear as you begin to answer the questions below.

Required.*

First name*

Please enter your first name.

Last name*

Please enter your last name.

Email*

Please enter a valid email address.

Cell phone*

Please enter a valid cell phone number.

Cell phone number must have at least 10 digits.

I am interested in LEQEMBI information for:*

Myself The person I care for

Please select an option.

Which statement best describes
you?*

Please select an option.

When did you start treatment with LEQEMBI?

What type of healthcare provider are you seeing?

Which statement best describes you?*

Please select an option.

When did the person you are caring for start treatment with LEQEMBI?

What type of healthcare provider are you seeing?

I certify that I am a U.S. resident 18 years of age or older and have read and accepted the Terms and Conditions. *

You must agree to all Terms and Conditions.

I agree to receive email communications from LEQEMBI.*

You must agree to receive email communications from LEQEMBI.

By clicking the checkbox, you authorize Eisai and its service providers to contact you and send the communications described above via telephone and text message. These calls or text messages regarding Eisai products and services may be generated using auto‐dial or pre‐recorded messages at the number you submit. Eisai’s Privacy Policy will govern the collection, use, disclosure, and retention of the information you provide. The number and type of messages will vary based on your program selections, and message and data rates may apply. This optional consent is voluntary and is not required as a condition of purchase or use of Eisai’s services. At any time, you may request to stop telephone calls or text messages by following the opt‐out directions provided during those communications.*

You must agree to the Privacy Policy/TCPA Terms and Conditions.

Personalized support throughout your treatment

IMPORTANT SAFETY INFORMATION

WHAT IS LEQEMBI?

WHAT IS LEQEMBI?

IMPORTANT SAFETY
INFORMATION

WHAT IS LEQEMBI?

SIGN UP FOR MORE INFORMATION

Personalized support throughout your treatment

IMPORTANT SAFETY INFORMATION

WHAT IS LEQEMBI?

WHAT IS LEQEMBI?

IMPORTANT SAFETY INFORMATION

WHAT IS LEQEMBI?

SIGN UP
FOR MORE INFORMATION

IMPORTANT SAFETY
INFORMATION