Patient Education Materials
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Patient Starter Kit
Patient educational kit for new patients on ARIXTRA that contains the following items: - Patient Education Booklet on deep vein thrombosis and pulmonary embolism (DVT/PE) as well as common questions and answers on ARIXTRA.
- Dosing Instruction booklet on how to administer the subcutaneous injection of ARIXTRA
- A Sharps infectious waste container
- Administration video for ARIXTRA
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Physician Information Materials
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Patient Education Video
Patient education video is intended to instruct patients on the proper injection technique for ARIXTRA. |
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Reimbursement Brochure
This brochure includes the following information: - Provides the Reimbursement Hotline number for ARIXTRA: 1-866-ARIXTRA (1.866.274.9872), Topic option: "Reimbursement questions"
- Describes the Support Hotline for ARIXTRA
- Provides Reimbursement Hotline rolodex card attachment
- Lists frequently asked questions regarding ARIXTRA, reimbursement services, and other information
- Information on ARIXTRA, the TogetherRx Program and commonly asked questions
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PDF File
(file size: 747 k)
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by mail (Packs of 5)
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Patient Education Brochure (English)
This booklet will: - Help patients learn about blood clots
- Explain why blood clots need to be prevented or treated
- Show the patient how to take ARIXTRA step-by-step
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Download
PDF File
(file size: 1.5 mb k)
or
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by mail (Packs of 10)
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Patient Education Brochure (Spanish)
This booklet will: - Help patients learn about blood clots
- Explain why blood clots need to be prevented or treated
- Show the patient how to take ARIXTRA step-by-step
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Download a digital file
now
Download
PDF File
(file size: 1.5 mb k)
or
Select quantity to order
by mail (Packs of 10)
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Discharge Planning Kit
Developed by GlaxoSmithKline for use by the Discharge Planner, this kit provides important information to help you inform and instruct patients on the home use of ARIXTRA. |
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by mail
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Non-Heparin Flash Card
The flash card provides an overview of properties, indications, and dosing information for ARIXTRA. |
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PDF File
(file size: 157 kb k)
or
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by mail (Packs of 10)
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Broadcast Licensing Release Form
Complete, sign, and fax the Release Form in order to broadcast the Patient Education Video in your institution. Please review the form for complete terms and conditions. The form must be completed and faxed to 215.751.6327. Attention: ARIXTRA Brand Management |
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PDF File
(file size: null k)
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Patient Authorization Form
Patient authorization form to release and disclose medical information for the purpose of receiving assistance from the GSK Reimbursement Resource Center. |
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PDF File
(file size: 18 kb k)
or
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by mail (Packs of 10)
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Benefit Verification Request Form
Form will allow patients or healthcare professionals to request patient-specific verification of benefits for ARIXTRA. |
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PDF File
(file size: null k)
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by mail
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