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Get and Sign Sublocade Extended Release 2018 Form

Get and Sign Sublocade Extended Release 2018 Form

Use a Sublocade Extended release 2018 template to make your document workflow more streamlined.

May only be delivered to a healthcare setting and is NEVER dispensed to a patient directly. Com. BriovaRx is REMS-certified and REMS authorized dispensing pharmacy. Provider Shipping Information O ffice Contact Shipping Address Date Medication Needed Faxed by This form is provided as a convenience to prescribers. All prescriptions for Sublocade should be sent directly to the REMS-authorized dispensing pharmacy. The pharmacy acknowledges that this form may not meet requirements for a valid...
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