Follow the steps to successfully submit your medical information request.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. In the first section, please enter the name of the requesting healthcare professional clearly in the provided space.
3. Next, include the title of the healthcare professional if applicable, followed by the institution name or office/practice name.
4. Fill in the street address, city, state, and zip code of your institution to ensure accurate processing of your request.
5. Provide the fax number and email address for future correspondence.
6. Enter a telephone number where you can be reached easily. This is important for any follow-up regarding your request.
7. Make sure to include your signature in the appropriate area. The request will not be processed without this signature, but a request received from a healthcare professional's email is acceptable as verification.
8. Specify the type of healthcare professional you are by selecting the appropriate option.
9. Indicate the product(s) of interest by checking the boxes next to the relevant items or writing additional products in the space provided.
10. Provide specific details regarding your inquiry in the designated area. The more detailed your information, the better we can assist you.
11. Answer whether there is any adverse drug experience associated with this question/request by circling 'Yes' or 'No'.
12. Finally, once all fields are properly filled, you have the options to save changes, download, print, or share the completed form.

Complete your Prometheus Medical Information Request online today to ensure timely access to the information you need.