By providing or making available my personal data in this form, I agree that Thomson Medical Group Limited and its related companies, representatives, agents and business partners may collect, use and disclose my personal data for the purposes of providing and administering registration form, medical treatment and other reasonably related purposes in accordance with the Personal Data Protection Act 2012 and Thomson Medical Group Limited's personal data protection policy. Thomson Medical Pte Ltd is carrying out introducing activities for Prudential Assurance Company Singapore (Pte) Limited ("Prudential") and Prudential Financial Advisers Singapore Pte Ltd ("PFA"), I acknowledge and understand the introducer-related disclosures indicated.

Please visit Thomson Medical Group Limited's website at https://www.thomsonmedical.com/personal-data-protection-policy for further details on Thomson Medical Group Limited's personal data protection policy, including how you may access and correct your personal data or withdraw consent to the collection, use or disclosure of your personal data.