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hcpsamplerequest.com - Novartis US

Health Care Professional Sample Request Form . Thank you for your interest in Novartis Pharmaceuticals Corporation. You may submit one request per month for each Health Care Professional. Please be sure to complete each of the required fields below when you submit your request. Your request will be reviewed for eligibility and will be addressed


HCP - xofluza.com

Request Samples. Request XOFLUZA sample courses of therapy. Give your patients the opportunity to experience a XOFLUZA sample course of therapy. A sample course of therapy shipment includes: One dose of two 20-mg tablets for a patient weighing 40 kg (88 lb) to less than 80 kg (176 lb)


Bayer Consumer Health - home

The information on this site is intended for healthcare professionals in the United States and is not intended for the general public.


Nutricia HCP

Customers in Northern Ireland should visit Nutricia.ie to order samples online. Orders are limited to 2 different products per order. We would recommend you allow 2-3 working days for delivery. If you prefer not to order online, please print out this form to order ONS samples or print out this form to sample from our pre-thickened range.


SAMPLE REQUEST FORM - LIVALO® (pitavastatin) for Managing

SAMPLE REQUEST FORM Dear Healthcare Professional: Thank you for requesting samples from Kowa Pharmaceuticals America, Inc. To receive samples of LIVALO® (pitavastatin) tablets, please take a moment to complete the bottom section of this form, sign and scan/email to [email protected] or fax to


APRISO (Mesalamine) Samples Request for HCP's

Request APRISO Samples. Help your patients make the move to APRISO by requesting samples today. After you have submitted the form below, a Salix representative will contact you about your request.


Pack Size - AproDerm

Free samples are available for Healthcare Professionals to give to their patients. To request any of the items listed below simply fill in the exact quantities that you require ensuring that you complete all fields marked with an asterisk* fully.


Resources for Healthcare Professionals | FYCOMPA (perampanel)

See tools and resources that you can use when prescribing FYCOMPA to your patients. See Safety and Box WARNING for serious psychiatric and behavioral reactions. Order from HCP Sample Portal. HCP Sample Portal helps simplify the process of ordering samples. Just enroll and, once your credentials are verified, you can have FYCOMPA samples


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