Anavex Life Sciences Corp (AVXL)

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PRE-SCREENING QUESTIONNAIRE TOOL
In general, you can visit the Website without telling us who you are and without revealing any personal information. However, in order to be considered for possible enrollment in an Anavex™-sponsored clinical trial, you will be asked to provide some personal information as part of a pre-screening questionnaire ("Pre-Screening Questionnaire"). The pre-screening questionnaire is a tool to identify if you pre-qualify for the clinical trial. However, completion of the Pre-Screening Questionnaire is voluntary and you may browse the Website without completing the Pre-Screening Questionnaire. The information you provide on the Website and Pre-Screening Questionnaire is forwarded to a clinical research organization (“CRO”) that is managing the clinical trial and a clinical site participating in the clinical trial (“Site”) and is not sent to Anavex™ or anyone else.


By your providing this personal information, and completing and submitting the Pre-Screening Questionnaire, you are consenting to the use and review of such information by the CRO and to forwarding this personal information with the Pre-Screening Questionnaire to the participating Site that has been selected. Your completing and submitting the Pre-Screening Questionnaire with your personal information will also constitute your request for follow-up communication to you regarding your interest to participate in the Anavex™-sponsored clinical trial. Anavex™ will not have any obligation to forward, respond to, or otherwise utilize any personal information or Pre-Screening Questionnaire that you provide that does not meet Anavex™'s qualifying criteria.