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