MDxHealth SA — Proxy Solicitation & Information Statement 2016

Apr 26, 2016

Free English translation for information purposes only

MDxHealth SA

Limited Liability Company

CAP Business Center Zone Industrielle des Hauts Sarts Rue d'Abhooz, 31 4040 Herstal, Belgium VAT BE 0479.292.440 RPM Liège

(hereinafter, the "Company")

ATTENDANCE FORM FOR SECURITY HOLDERS

ANNUAL AND EXTRAORDINARY GENERAL MEETINGS

to be held on Friday, May 27, 2016 at 10.00 a.m.

This is an unofficial English translation, for information purposes only. Please only sign and return the original French version.

This attendance form should be used by holders of securities who want to attend the annual and extraordinary general shareholders' meetings in person.

The signed and completed form must reach the Company at the latest on the sixth calendar day prior to the annual and extraordinary general shareholders' meetings, i.e. on or before Saturday May 21, 2016 at the latest, by mail to:

MDxHealth SA Attention Veronique Denis Company Secretary Cap Business Center Zone Industrielle des Hauts Sarts Rue d'Abhooz, 31 4040 Herstal, Belgium

or by e-mail to:

agsm@mdxhealth.com

Prior to Friday, May 20, 2016, holders of securities can also register for the annual and extraordinary general shareholders' meetings via the counters of ING Belgium. Holders of dematerialized securities must attach to the present form a certificate issued by the applicable settlement institution for the securities concerned, or by a certified account holder, confirming the number of securities that have been registered in their name on the registration date, (i.e. Friday May 13, 2016, at midnight (12:00 a.m., Central European Summer Time)) with which they want to participate to the annual and extraordinary general shareholders' meetings.

The undersigned,

First Name:	…………………………………………………………………
Family Name:	…………………………………………………………………

Address:	…………………………………………………………………
or
Corporate name:	…………………………………………………………………
Corporate form:	…………………………………………………………………
Registered office:	…………………………………………………………………
	…………………………………………………………………
Represented by (first name, family name and capacity):	…………………………………………………………………
	…………………………………………………………………
	…………………………………………………………………
	…………………………………………………………………

owner of the following number(s) of securities issued by the limited liability company, MDxHealth, with its registered office at CAP Business Center, Zone Industrielle des Hauts Sarts, rue d'Abhooz 31, 4040 Herstal, Belgium:

Number of shares	………………
Number of warrants	………………

Hereby notifies his/her/its intent to attend the annual and extraordinary general shareholders' meetings of MDxhealth SA to be held at Regus Brussels, Pegassuslaan 3, 1831 Diegem, Belgium on Friday May 27, 2016 at 10.00 a.m., or at such other place indicated at that place at that time.

Done at ……………………………………., on ………………………………2016

Signature……………………………