Get Allergan Device Tracking
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How to fill out the Allergan Device Tracking online
This guide provides a clear and comprehensive overview of how to fill out the Allergan Device Tracking form for Natrelle Silicone-Filled Breast Implants and Natrelle 410 Highly Cohesive Anatomically Shaped Silicone-Filled Breast Implants. Follow the steps below to ensure the form is completed correctly and efficiently.
Follow the steps to complete the device tracking form.
- Press the ‘Get Form’ button to access the necessary document and open it in your preferred editor.
- Complete the section labeled 'Device and Surgery Information.' Attach the breast implant label from the product box to page 1 of the form. For each breast implant, indicate left or right and provide the catalog number (REF) and serial number (SN) if labels are unavailable.
- Fill out the 'Implanting/Explaining Physician Information' section with the last and first name, address, city, state/province, email, zip/postal code, telephone, and fax of the responsible physician.
- Enter the attending or following physician information if it differs from the implanting physician. Include the same details as in the previous step.
- Complete the 'Patient Information' section. Include the last name, first name, address, city, state/province, date of birth, social security number (if required), zip/postal code, and telephone number.
- If applicable, complete the section 'Complete Only for New Devices Opened and Discarded/Destroyed.' Provide the serial number, date of disposal, and reason/comments.
- For devices removed, fill out the explanted device information, including the date of explantation, serial numbers, reasons for removal, and original implanting physician's information.
- Review all information for completeness and accuracy. Once verified, fax page 1 to Allergan at the indicated number and provide page 2 to the patient for enrollment in the Device Tracking program.
- If any patient does not wish to participate in the Device Tracking program, they should indicate this on the appropriate checkbox.
- Ensure that the form is securely saved, printed, or shared as needed after completing all required fields.
Encourage others to complete their documents online for quick and efficient tracking.
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Generally, it is possible for someone to notice implants, particularly if they are familiar with certain characteristics or features. However, many factors can influence noticeable differences, such as the type of implant and body placement. Feeling comfortable and confident is essential, and understanding your implant through tools like Allergan Device Tracking can help you appreciate what you have. Ultimately, the focus should be on how you feel about your choices regarding your health and appearance.
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