Get the free PrXELJANZ and PrXELJANZ XR ENROLMENT FORM
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Call 1855935FLEX (3539)Enrollment FORM fax 1833958FLEX (3539) email inflectra@pfizerflex.comPATIENT INFORMATIONPHYSICIAN Informational:Physician Name:License no.:Address:Tel. (Home):Leave messages:Address:
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01
Make sure to read the provided patient information leaflet before starting to fill out the prescription for Prxeljanz and Prxeljanz XR.
02
Fill out the patient's name, date of birth, and any other required personal information accurately.
03
Specify the dosage and strength of Prxeljanz or Prxeljanz XR that is being prescribed.
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Include any relevant instructions for taking the medication, such as whether it should be taken with food or at a certain time of day.
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Sign and date the prescription form before submitting it to the pharmacy for processing.
Who needs prxeljanz and prxeljanz xr?
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Prxeljanz and Prxeljanz XR are medications prescribed for patients with moderate to severe rheumatoid arthritis, psoriatic arthritis, or ulcerative colitis.
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Those who have not responded adequately to other treatments or are unable to tolerate other medications may also be candidates for Prxeljanz and Prxeljanz XR.
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What is prxeljanz and prxeljanz xr?
Prxeljanz and Prxeljanz XR are medications used to treat conditions such as rheumatoid arthritis, psoriatic arthritis, ulcerative colitis, and other autoimmune diseases.
Who is required to file prxeljanz and prxeljanz xr?
Healthcare providers and pharmacies are required to file prxeljanz and prxeljanz xr.
How to fill out prxeljanz and prxeljanz xr?
Prxeljanz and Prxeljanz XR forms can be filled out online or submitted by mail with all relevant information and signatures.
What is the purpose of prxeljanz and prxeljanz xr?
The purpose of prxeljanz and prxeljanz xr is to track the dispensing of these medications and monitor patient outcomes.
What information must be reported on prxeljanz and prxeljanz xr?
Information such as patient name, date of birth, prescription details, prescribing physician, and dispensing pharmacy must be reported on prxeljanz and prxeljanz xr.
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