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PATIENT KIT ORDER FORM
Patient
Kit: Receive the patient kit, which provides a comprehensive overview
of IPF including an educational patient brochure, video, and DVD.
To order, please fill out the form below. (* required
field)
InterMune is committed to protecting the privacy of your
personal information. The information you give will only be used to provide
you with the materials specified. When you submit personally identifiable
information you consent to its disclosure and use for these purposes. We
may share your information with our partners who facilitate the delivery
of these materials. If you ever decide that you do not wish to receive
further materials or if you have any comments or questions regarding this
Web site, please send an e-mail to medinfo@intermune.com.
We will address any issues to the best of our abilities.
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