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1. www.mirenahcp.comMirena® IUD | Official HCP Website

   www.mirenahcp.com

   • Αποθηκευμένο αντίγραφο

   View clinical information about Mirena® (levonorgestrel-releasing intrauterine system) 52 mg IUD, including how to order. See full prescribing and safety info.

   • Ordering and Reimbursement

     Ordering and Reimbursement - Mirena® IUD | Official HCP...

   • Insertion and Removal

     Follow the insertion instructions exactly as described in...

   • Downloadable Resources

     Downloadable Resources - Mirena® IUD | Official HCP Website

   • About Mirena

     Mirena, the #1 prescribed IUD* in the U.S., may be...

   • Safety

     Some serious complications with IUDs like Mirena are sepsis,...

   • Request A Rep

     Request A Rep - Mirena® IUD | Official HCP Website

   • Mirena Efficacy

     Mirena ® IUD Efficacy. Pregnancy prevention for up to 8...

   • Contact Us

     Contact Bayer about Mirena® (levonorgestrel-releasing...

2. www.gramercygynecology.com › pdfs › skyla-mirena-order-form-newBayer Women’s HealthCare Support Specialty Pharmacy Prescription...

   www.gramercygynecology.com › pdfs › skyla-mirena-order-form-new

   To order Kyleena, Mirena or Skyla, complete the Specialty Pharmacy Prescription Request Form as follows: 1. Select Specialty Pharmacy. 2. Enter the patient and prescriber information in the space provided on the Specialty Pharmacy Prescription Request Form, including the patient’s pharmacy drug benefit and medical insurance information.

3. www.whcsupport.comBayer Women's Health Care(WHC) Support Center

   www.whcsupport.com

   • Αποθηκευμένο αντίγραφο

   Forms. Click below for additional information on ordering and reimbursement forms for Kyleena, Mirena, and Skyla. Learn More. Bayer can help your patients. with product costs. Bayer offers a patient assistance program that provides Kyleena, Mirena and Skyla Intrauterine Devices at no cost for eligible patients. Learn More.

4. www.whcsupport.com › formsBayer Women's Health Care (WHC) Support Center

   www.whcsupport.com › forms

   • Αποθηκευμένο αντίγραφο

   WHC Support Center Forms. Ordering and Reimbursement for Kyleena, Mirena, and Skyla

5. gentlehandsobgyn.com › wp-content › uploadsPrinted name of Individual or Individual’s representative

   gentlehandsobgyn.com › wp-content › uploads

   please fax the prescription request form, including the signed patient authorization section on this page. Please see Important Safety Information for Kyleena, Mirena or Skyla on third page and accompanying full Prescribing Information for Kyleena, Mirena and Skyla.

6. www.mirena-us.com › piPrescribing Information | Mirena® IUD Patient Website

   www.mirena-us.com › pi

   • Αποθηκευμένο αντίγραφο

   Read Mirena® (levonorgestrel-releasing intrauterine system) 52 mg full prescribing information to learn about dosage and administration. See safety information.

7. www.caremark.com › portal › assetMirena Specialty Pharmacy Prescription Request Form - CVS...

   www.caremark.com › portal › asset

   To order Mirena®, complete the Prescription Form as follows: 1. Enter the patient and health care provider information in the space provided on the Prescription Request Form including the patient’s pharmacy drug benefit and medical insurance information. • Please ensure that all information is complete