By providing your name, address, and other personal information, and
by clicking the "Submit" button below, you agree to permit Merck, and others working on behalf
of Merck, to use this information to provide the information about GARDASIL
® [Human Papillomavirus Quadrivalent (Types 6, 11, 16, and 18) Vaccine, Recombinant] that you have requested.
Occasionally, Merck sends e-mail and other communications about new resources or services related to
GARDASIL. Please check the box below this paragraph if you would like to receive additional information
in the future about GARDASIL. Also, at any time, you can request a copy of your selections
on this form and that personal information about you be removed from the Merck contact list
for GARDASIL by calling 1-888-776-8364.