SAMPLE REQUESTS

Takeda provides healthcare professionals with access to product samples with the aim to support informed prescribing practices and enhance patient care.

To complete a request for INTUNIV samples, please follow the below steps:

Download

STEP 1: DOWNLOAD THE SAMPLE REQUEST FORM

Please click the 'DOWNLOAD' button below to download the INTUNIV Sample Request form.

DOWNLOAD
Form

STEP 2: COMPLETE AND UPLOAD THE FORM

Open and complete the downloaded form by filling in all of the required fields. Once completed, save the form to your device and upload it via the 'UPLOAD' button below.

Upload

STEP 3: SUBMIT YOUR REQUEST

Once you have uploaded the completed form, please finalise the submission by clicking 'SUBMIT' below.

PBS Information: This product is listed on the PBS. Authority required. Refer to PBS Schedule for full authority information.

Click here to review full approved Product Information before prescribing.

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