Sign up for IS RQ-PCR testing

No-cost routine monitoring for your eligible patients*

*Limitations Apply. Non-US residents, patients covered under Medicare, Medicaid, or a similar state or federal program, and residents of Massachusetts and Michigan are not eligible for the Get IS RQ-PCR Now program. Novartis reserves the right to rescind, revoke, or amend the program without notice.

Privacy Notice:

Novartis Pharmaceuticals Corporation and Novartis Group of Companies understand that your personal and health information is private.

The personal information we collect from you will be used to bring you information about products, programs, support, and services, to conduct market research, and as provided in our Privacy Statement. Please be assured that although we share your personal information with our business partners who work with us on these activities, we do not permit them to use your personal information for their own marketing purposes.

I agree to receive marketing information, offers and promotions regarding IS RQ-PCR testing and also agree that I may be contacted for my opinions regarding products, programs, support, and services.

I understand that the information that I provide will be used in accordance with the above Notice and the Novartis Privacy Statement. My consent will remain valid until I unsubscribe.

Account name (name of facility)

Physician first name

Physician last name

National Provider Identifier (NPI)

Shipping address 1

Shipping address 2

City

State

Zip code

Phone

Fax

Error message

Facility contact (if different from physician)

Error message

E-mail address

Number of kits requested

Select lab

"The selected lab will acknowledge receipt of this form within 1 business day. The acknowledgment will be sent either via fax or e-mail. Please indicate your preference below.

Fax

E-mail

By clicking SUBMIT, I give Novartis permission to forward my information to the lab I have selected. I understand the lab will contact me to confirm my request, send a test kit(s) at no cost to the address I have provided, and alert me when the test has shipped.

Optional information.

IS, International Scale; RQ-PCR, real-time quantitative polymerase chain reaction.