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Welcome to our investor request form. Please let us know what investor information you are interested in and how you would prefer to be contacted.

Use the form below to submit your request for investor information. After you have completed the form just click the "Submit Form" button and you will be prompted on how to return to the web site.

In using the form below, you have chosen (Opt-in) to provide us with personable identifiable information (PII). Any PII provided to us through the use of this form will be used for the sole purpose of identification or to contact you as per your editorial comment. (For more information regarding PII, please read below or our privacy statement.) If you choose not to submit comments through this form, you may choose not (Opt-out) to submit PII by not completing the form and use information found on the "Contact Us" page to submt your comment.


Items marked with an * are mandatory

*Company/Organization
Company Description
Prefix/Title
*First Name
*Last Name

Address - Line 1
Address - Line 2

City

State/Province

Zip Code

*Email Address

*Email Confirmation

*Contact Phone Number
Are you presently an A.D.A.M. Customer?
Yes No
How did you hear about us?
Would you like to receive future email updates from A.D.A.M. ? Yes No

Please indicate all of the products that interest you:
Consumer Health Information

Communications Technology

ICD-9 or CPT Tagged Health Information

 Health Images/Illustrations

 Custom Development

K-12 and Higher Education Products
Questions/Comments: (Maximum characters: 250)


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This form collects personal information via unsecured email. A.D.A.M., Inc. will not without your permission, give out your name, company, phone number, residence address, or e-mail address to any third parties, for any reason, at any time, ever. A.D.A.M. editorial associates will review the request, qualify the request and enter your supplied information into a secure database, accessible only to select A.D.A.M. employees. This information is stored in the A.D.A.M. database indefinitely, or until you submit a request for the information to be removed. You may request that your information be deleted from the database at any time by clicking the "Remove My Contact Information" link supplied above.

Any personable identifiable information (PII) provided to us through the use of this form will be used for the sole purpose of identification in the event we need to contact you for clarification. We will not respond to you unless specifically requested to do so, or in the event we have questions regarding your comment. If a response is requested, we will make every attempt to contact you within three (3) business days.

Free-text e-mails and online forms are not secure. Do not submit Personal Health Information (PHI) to A.D.A.M. via e-mail or through the use of these forms. (For more information regarding PHI or PII, please read our privacy statement.)

A.D.A.M., Inc. may not notify you of changes to this privacy statement or privacy practices. If we make material changes in our privacy practices that do not affect user information already stored in our database, we will post a prominent notice on your web site notifying users of the change. If we are going to use your personally identifiable information in a manner materially different from that stated at the time of collection we will notify you via email, and you will have a choice as to whether or not we use your information in this different manner. However, if you have deleted/deactivated your account, then you will not be contacted, nor will your personal information be used in this new manner.
 
     
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