Patient Registry Privacy Notice

Introduction

Motif Neurotech, Inc. (“Motif”) is currently developing technologies that may be granted an investigational device exemption for potential future clinical study. 

In order to understand the treatment preferences of those suffering from illnesses that may be treated with technologies in the future, Motif provides interested individuals, and or their caregivers and providers, the opportunity to submit certain information to Motif’s Patient Registry. 

Motif may use this submitted information in the manner described below, including to contact the submitter with additional inquiries or requests for information related to Motif’s Patient Registry. 

This Patient Registry Privacy Notice, together with Motif’s Terms of Use and Privacy Policy, govern the treatment of such information submitted to the Motif Patient Registry, or information provided to Motif that is related to Motif’s Patient Registry. 

Information Collected by Motif’s Patient Registry 

Interested individuals may elect to submit information to Motif’s Patient Registry online at trials.motifneuro.tech. If so, Motif will collect your first and last name, your email address, and your state and zip code of residence. You may also submit certain medical information. 

Motif may use this information to contact you regarding your Patient Registry Profile, where you may have the option to provide additional information such as demographic information, medical history, family health history, and information about any medications or other medical device usage.

For caregivers or providers of interested individuals, you may elect to submit your own contact information to Motif’s Patient Registry using the URL provided above. If so, Motif will collect your first and last name, your email address, and your state and zip code of residence. 

Or, you may submit information of the interested individual on their behalf, and only with their appropriate consent. If so, Motif will collect the interested individual’s first and last name, email address, and state and zip code of residence. Motif may also collected certain medical information of the interested information. Motif may use this information to contact you or the interested individual regarding their Patient Registry Profile, where you or the interested individual may have the option to provide additional information, such as demographic information, medical history, family health history, and information about any medications or other medical device usage.

How We Use Patient Registry Information

Motif may use any of the information you submit to build a Patient Registry Profile. Motif may use this Patient Registry Profile to understand your preferences with respect to your care; to determine your interest in participating in current or future Motif clinical trials should Motif obtain appropriate regulatory approval for such trials; to determine preliminary eligibility for current or future Motif clinical trials should Motif obtain appropriate regulatory approval for such trials; to communicate with you about Motif’s DOT device and related clinical trials should Motif obtain appropriate regulatory approval to do so; or for the uses identified in Motif’s Privacy Policy. 

For interested individuals who meet certain preliminary eligibility requirements for Motif’s future clinical trials should Motif obtain appropriate regulatory approval for such trials, Motif may provide you information regarding ways in which to participate. 

Your Rights to Patient Registry Information

You may have some of the rights related to the information you provide to Motif. Please review Motif’s Privacy Policy at www.motifneuro.tech/privacy-policy to review these rights and how you may exercise them. Further, Motif’s Privacy Policy includes information on how to contact Motif for any questions. 

Voluntary Submission, No Guarantee, No Claims Made

Submitting information to Motif’s Patient Registry, is voluntary, uncompensated, and is not required in order to participate in any of Motif’s current or future clinical studies should Motif obtain regulatory approvals for such trials. Should Motif obtain appropriate regulatory approval to conduct future clinical trials, Motif does not guarantee participation in future trials by virtue of submitting information to Motif’s Patient Registry, even if an interested individual meets the certain preliminary eligibility requirements for Motif’s future clinical studies. Motif does not assert any claims regarding the effectiveness of any device, nor does the Patient Registry reflect a solicitation to join a clinical study. All Motif’s clinical studies shall be governed by separate informed consent agreements and associated medical oversight, and only after obtaining appropriate regulatory approvals.

Updates

This Patient Registry Privacy Notice may be updated periodically by Motif. The date on which this current Patient Registry Privacy Notice is updated can be found at the top of this page.

‍