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Patient Assistance Information

 
 
 
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