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Free Patient Information Kit - Learn More About PT/INR Self Testing

To speak directly with a Philips representative who can answer your questions about self-testing, please call the toll-free number at the right of your screen. Our offices are open between 8:30am and 6pm Eastern Standard Time.

For more information about PT/INR self-testing, insurance coverage and enrollment forms, please complete the form below. Please be assured that all information is held in strict confidence.

Patient Information
* First Name
* Last Name
* Address
* City
* State
* Zip
Telephone Number
Your email address
* How long have you been on Coumadin or other anticoagulant medication?




* Why did your doctor prescribe this medication for you?
(check all that apply)
* We can help with your insurance questions and the enrollment process by talking with your doctor. May we contact your doctor?
* Doctor Name
* Doctor Phone
* Your date of birth (Needed for I.D. purposes)
Comments
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field empty

 
 
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