Eligibility & Documentation
Confirmation & Submit
Celgene Patient Support® is committed to using our best efforts to protect your privacy. While the security of information in transit over the Internet cannot be assured, our privacy practices are designed to protect personally identifiable information and to ensure that we use information we receive in ways compatible with the purposes for which it has been collected. All the information provided in this online enrollment form will be sent in an encrypted form and then stored in a secure Celgene Database.
The information provided is for Celgene Patient Support® use only and will not be shared outside of Celgene Patient Support® and its authorized representatives, agents, and individuals or entities involved in processing this application and implementing a Celgene Patient Support® program for which you may qualify. These may include your Healthcare Professional and health insurance provider. If you have questions about the privacy of your information, e-mail email@example.com or write to Celgene Corporation, 86 Morris Avenue, Summit, NJ 07901. Attention: Privacy Office.
REVLIMID® (lenalidomide), POMALYST® (pomalidomide), and THALOMID® (thalidomide) are only available through restricted distribution programs.
Please see full Prescribing Information, including Boxed WARNINGS, for REVLIMID®, POMALYST®, THALOMID®, IDHIFA® (enasidenib), and ABRAXANE® for Injectable Suspension (paclitaxel protein-bound particles for injectable suspension) (albumin-bound). Please see full Prescribing Information for VIDAZA® (azacitidine for injection).
Your Specialist is assigned based on the zip code of your doctor’s office. To meet your Specialist, enter the zip code of your doctor’s office below.
This website is intended for
US healthcare professionals only
The ICD-10-CM Codes provided here are for diagnoses reasonably related to an indication or indications within the product’s approved label and are provided for your reference only. Other codes may be appropriate. Celgene makes no representation that any code is appropriate for a particular patient. Healthcare Professionals must use their independent judgment in selecting Code(s) to accurately reflect the diagnosis of the specific patient.