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Patient Assistance Information

 
1 Program for Entereg capsule
 
 
Entereg Access Support and Education (E.A.S.E.)


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Phone : 877-282-4786 Ext opt4
Fax: 800-278-1365
Eligibility
> This program is for healthcare professionals only. Insurance, income and residency requirements have not been disclosed for this program.
Who Can Apply
> The doctor or the doctor's office must call or download an application.
Required
> The patient must inform the doctor that he or she is in need. The hospital contact must complete, sign and fax the form.
Supply
> Varies
Ship To
> Hospital
Note
> Resources for HEALTHCARE PROFESSIONALS ONLY. Entereg is available only to hospitals that enroll in the E.A.S.E. Program and is available only for short-term (15 doses) use in hospitalized patients.
 
Includes Support for This Drug
NOTE: Linked drugs are available for Prescribers to Apply Online now.
Click drug logo or drug name to start online application.
 
Entereg capsule
 
Printable Application Forms
Applications that patients can fill out and bring to their doctor.
 
Download printable Form
Download printable Form
Download printable Form
(Requires Acrobat Reader