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Pulmozyme Access Solutions™

For help with insurance information:

Pulmozyme Access Solutions
800-690-3023

Join us for an interactive patient, physician and caregiver experience giving valuable information on dealing with the challenges of cystic fibrosis.

To register for the webcast, please provide the below information:

Basic Information

Thank you for your interest in registering for the webcasts. Please select one or both webcasts below.

check all that apply

First Name:

Last Name:

Date of Birth:

Gender: Female Male

Click on the option that applies to you

What is your relationship to the person with CF?

I have CF I am a Health Care Professional I am the spouse I am the mother I am the father I am the friend I am the relative I am a friend and the primary caregiver I am a relative and the primary caregiver

If the individual registering is the caregiver, physician or friend of a person with CF

First Name of Person with CF:

Last Name of Person with CF:

Date of Birth of Person with CF (if known):

Gender of Person with CF: Female Male

Your E-mail Address:

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City

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How did you hear about the webcast?

Through my physician E-mail PZ website CF Living website CF related sites Other

During the webcasts, Dr. Katz and Dr. McColley will answer your questions live. Please enter any relevant questions that you would like answered by Dr. Katz or Dr. McColley here:*

* Due to the limited time available for Q&A, some questions may not be covered.

Privacy Information

Genentech respects your privacy and is committed to using every means possible to protect it. Genentech will never sell your information to anyone, any business, or any Internet service. For more information, read our privacy policy.

You must be 18 years of age or older to submit registration or survey information. If you are under the age of 18 and wish to register to obtain further information or be included in a survey, then your parent or legal guardian must register to obtain the information or to participate in the survey.

The contents of this message are not intended for the purpose of disease diagnosis or as a substitute for information that is provided to you by your physician. You should always discuss your individual symptoms and any questions you have with your physician.

Important Safety Information

Pulmozyme should not be used in patients who are allergic to any of its ingredients. Pulmozyme should be used in conjunction with standard therapies for CF. When starting Pulmozyme therapy, patients may experience change in or loss of voice, discomfort in the throat, chest pain, red watery eyes, rash, dizziness, fever, or runny nose. These side effects are usually mild and short-lived.

Pediatric Use

There is a limited amount of information available concerning the usage of Pulmozyme in patients who are younger than 5 years. The decision to use Pulmozyme in these patients is made after considering the potential for a benefit in lung function or in decreasing the risk of RTEs.

For further information, please see the Pulmozyme full prescribing information. If you have questions, please discuss them with your CF healthcare team.

Customer Contact Center

Pulmozyme Access Solutions™

Webcast Registration

Basic Information

Privacy Information

Important Safety Information

Pediatric Use

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