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  • Compassionate Care Rebate Program Enrollment - Fertility Lifelines

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Compassionate Care Rebate Program enrollment instructions Print this page Complete the Compassionate Care Rebate Program mailin rebate form below Attach the ORIGINAL pharmacy receipt Valid receipt.

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-F, Redi-Ject, , and are registered trademarks of Merck KGaA, Darmstadt, Germany or its affiliates. Fertility LifeLines is a trademark of Merck KGaA, Darmstadt, Germany or its affiliates.

-f ( alfa) is a medication that contains a hormone found naturally in the body called follicle stimulating hormone (FSH). In women, FSH helps the ovaries get eggs ready for ovulation.

-F, Puregon and Pergoveris are made from Chinese hamster ovary cell lines and (which has LH activity) is made from urine of menopausal and pregnant women which has been highly purified.

What is the Compassionate Care Program? The EMD Serono Compassionate Care Program provides fertility medication savings to eligible self-pay patients, pursuing infertility treatment, based on financial need or military status.

® - Expertise | Merck Global.

Headache, mild stomach/abdominal pain, bloating, redness/pain at the injection site, or breast tenderness/pain may occur. If any of these effects last or get worse, tell your doctor or pharmacist promptly.

-f® - Expertise | Merck Global.

For inquiries or questions related to the patient's eligibility, drug copay or medication delivery; please contact the Specialty Customer Care Team: CaremarkConnect® 1-800-237-2767.

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Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232