Please complete the form below and BioPlus will have a representative contact you as soon as possible OR Use this page to submit a question to any or all of the members of the HCV Advisory committee.
All fields marked with (*) are required.
* First Name:
* Last Name:
City:
State: Choose One! Florida Alabama Alaska American Samoa Arizona Arkansas California Colorado Connecticut Delaware District Of Columbia Federated States Of Micronesia Florida Georgia Guam Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Marshall Islands Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Northern Mariana Islands Ohio Oklahoma Oregon Palau Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virgin Islands Virginia Washington
Phone:
Fax:
* E-mail:
I am a: Choose One! Healthcare Provider Patient Insurance Provider Pharmaceutical Representative Other
Interested in Choose One! Ask a Pharmacist Disease Management Home delivery programs Insurance verification Patient compliance PAYERAssist RX cost Specialty Pharmacy services Other
Please check this box if you are submitting a question for the Advisory Committee
Best time to reach me is: Anytime AM PM
Best way to reach me is: phone email fax
Comments:
For Patients If you would like to have BioPlus deliver your prescription, or if you have questions about your insurance, medication or illness, contact us
For Physicians If you have a prescription to send to BioPlus Specialty Pharmacy, please use our Patient Enrollment Form (requires Adobe)
For more information about the Community Health Accreditation Program go to www.chapinc.org
New York Times addresses Health Plan involvement in Specialty Drugs