Coverage Gap Discount Program
Manufacturer Webinar Registration
To register for the manufacturer webinar to be held on TBA , please enter the requested information below.
Webinar Registration Page
** All fields are required
I am a
:
Drug Manufacturer
-> Enter P-number
(If you have multiple P-numbers, enter only one)
Third Party Vendor
-> Enter X-number
(If you have multiple X-numbers, enter only one)
If none of the above, please call 877-534-2772 to register.
Name of Company
:
Contact Person Name
:
(Contact info used for webinar communication only)
Contact Person Title
:
Contact Person Email
:
Version 2.0, February 25th 2013