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Web download enrollment form to take to your doctor. Completion takes about 15 minutes. Write a prescription for pemazyre®. (page 1 of 4) please legibly complete all fields not marked optional, for timely processing.

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Write a prescription for pemazyre®. (page 1 of 4) please legibly complete all fields not marked optional, for timely processing. Web if you are eligible for the program, your doctor will need to complete and submit the prescription and enrollment form for opzelura. Completion takes about 15 minutes. Commercial access program for opzelura.