
To get started, select a category above or call 855-404-5278 to speak with a representative, Monday through Friday, 8AM to 8PM ET
To get started, select a category above or call 855-404-5278 to speak with a representative, Monday through Friday, 8AM to 8PM ET
Learn More About Enrollment
THE MERCK ACCESS PROGRAM
THE MERCK ACCESS PROGRAM
Enrollment Form
Helpful HintsOR
Spanish Enrollment Form
Helpful HintsElectronic Healthcare Provider Enrollment Form
The patient must also submit the Electronic Patient Enrollment Form.
Helpful HintsDoes your patient have a legal and/or personal representative who is assisting them? If so, it’s important that you have the representative fill out this form.
Use this link to securely upload documents to submit to The Merck Access Program.