Does the patient have a
Prolia?? (denosumab) Co-pay Card?
Yes
Please enter the following information to verify the card and check patient registration.
No
Please click the button below to begin the registration process.
Prolia?? Co-pay Card is verified.
However, the patient must register.
Please click the button below to begin the registration process, which must be completed before the card is ready to use.
Need help? Call the Prolia?? Co-pay Program at 1-844-369-9962 for assistance.
Downloadable Forms
Privacy Notice and Patient Authorization Form for the Prolia® Co-pay Program
Check Request Form for the Prolia® Co-pay
Program