| |
Zevalin Results
|
PO Box 222007
Charlotte, NC 28222-2007
Phone
:
800-386-9997
Fax:
800-513-8095
|
|
Eligibility
|
| > |
This program is based on guidelines that are not disclosed. The patient must also be a US resident. |
| Who Can Apply
|
| > |
With the patient's permission, anyone concerned can call for an application. |
|
Required
|
| > |
The doctor must fill out a section and sign the application.The patient must fill out a section and sign the application. |
|
Supply
|
| > |
The medication is sent one treatment cycle at a time |
|
Ship To
|
| > |
Doctor's office |
|
Note
|
| > |
With the patient's permission, anyone concerned can call for an application. |
| |
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.
|
| Yttrium-90 Zevalin Kit |
| Zevalin Kit-Indium-111 |
| |
Printable Application Forms
Applications that patients can fill out and bring to their doctor.
|
| Download printable Form Application Form |
(Requires Acrobat Reader) 
|
| |
|
|