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* Denotes mandatory fields.
First Name*
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To report SUSPECTED ADVERSE REACTIONS, contact Azurity Pharmaceuticals at
1-855-379-0383, or FDA at 1-800-FDA-1088 or www.fda.gov/MedWatch.
By clicking submit, you agree to disclose your personal information to Azurity and to be contacted by Azurity, its affiliates, and business partners in the future regarding products, services, and/or information related to Eprontia. Azurity will not sell your information to any third party for marketing purposes without your express consent.
By clicking send, you agree to our Terms of Use and that you have read our Privacy Policy, including our Cookies Notice.
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