SUPPORT RESOURCES

RESOURCE
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Electronic Enrollment
The Merck Access Program Electronic Patient Enrollment Form This patient form can be signed and submitted electronically. Please note that your health care provider must also submit the Health Care Provider Enrollment Form.

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Enrollment
The Merck Access Program Enrollment Form

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Available Independent Foundation Support
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Representative’s Form
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Patient support materials
ZINPLAVA.com
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Product information
Physician Prescribing Information
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Patient Information
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Questions? Contact The Merck Access Program at 877-709-4455 Mon–Fri, 8 AM to 8 PM ET, to speak to a representative.

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