WELCOME TO

THE ORGANON ACCESS PROGRAM

ARE YOU A US HEALTH CARE PROFESSIONAL?
The Organon Access Program for RENFLEXIS® (infliximab-abda)
RENFLEXIS® (infliximab-abda) for injection, for intravenous use 100 mg
Physician Prescribing Information Medication Guide
Health Care Professionals Patients and Caregivers
Medication Guide Physician Prescribing Information
The Organon Access Program for RENFLEXIS® (infliximab-abda)
Please read the Medication Guide for RENFLEXIS,
including the information about serious infections and
cancers, and discuss it with your doctor. The physician
Prescribing Information also is available.
RENFLEXIS® (infliximab-abda) for injection, for intravenous use 100 mg
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Contact The Organon
Access Program at 866-847-3539
Mon-Fri 8 AM to 8 PM ET

ENROLL NOW

Please click on the links below to access The Organon Access Program forms that are applicable to you. If you are requesting a referral to the Organon Patient Assistance Program, be sure to include all information, including a prescription from your health care provider for RENFLEXIS. Please be sure all signatures are included prior to submitting forms to The Organon Access Program.

Download and Print the RENFLEXIS® (infliximab-abda) Enrollment Form

DOWNLOAD &
PRINT

This form can be downloaded and printed, and
requires an original signature. Work with your health
care provider to complete the enrollment form.

2023 Enrollment Form

Use this form to re-enroll in
The Organon Access Program for 2023.

Download and Print the RENFLEXIS® (infliximab-abda) Enrollment FormDownload and Print the RENFLEXIS® (infliximab-abda) Enrollment Form

SIGN & SUBMIT ELECTRONICALLY

This patient form can be signed and submitted electronically. Please note that your health care provider must also submit the Health Care Provider Enrollment Form.

2023 Electronic Patient Enrollment Form

Use this form to re-enroll in
The Organon Access Program for 2023.

ENROLLMENT ASSISTANCE

2023 Sample
Enrollment Form

Download and use this form as a guide
for completing the enrollment form.

This site is intended only for residents of the United States, its territories, and Puerto Rico.
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