Join UP for Support and Resources
Models
Join UP for Support and Resources
Models

UP Support Program brought to you by Merck

Sign up with the UP Support Program to learn more about NEXPLANON. You'll receive a short series of e-mails that will provide information about NEXPLANON so you can discuss with your health care provider.

Merck’s Privacy Commitment

The information you provide will be available to the Merck & Co., Inc., family of companies (collectively, “Merck”) and others working on behalf of Merck, to provide the information and services you request. Personal information about you will not otherwise be disclosed for marketing purposes without your permission. Merck reviews personal information and nonidentifiable information not only to provide the requested information and services but also to develop and offer additional services and communications that we believe our customers might find of interest. Merck also may use personal information to audit its resources for compliance and security purposes. For more information about how Merck protects personal information about you, please read our Internet Privacy Policy and Privacy Commitment for US patients, consumers, and caregivers.

*Required fields, answers must be provided
Please fill the required fields.
You must be female and 18 years or older

Have you discussed NEXPLANON with your health care provider?

When did you receive the implant?

By providing your name, address, and other personal information above and clicking the “submit” button below you agree to permit Merck and others working on behalf of Merck to use this information to provide you with information, resources, services, and communications about NEXPLANON related treatment options via e-mail or otherwise. Additionally, your information may be used for market research purposes.

At any time, you can request a copy of this permission, and that personal information about you can be removed from the Merck contact list for NEXPLANON by calling 1-888-776-8364. Unless you change this selection sooner, your permission will expire 1 year after Merck no longer promotes NEXPLANON.

By clicking “submit” I am signing this form. I agree that my information may be used as described above, as well as for market research purposes.

Submit
 

NEXPLANON is a prescription medication for the prevention of pregnancy in women.

IMPORTANT SAFETY INFORMATION

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.

Please read the accompanying Patient Information for NEXPLANON and discuss it with your health care provider. The physician Prescribing Information also is available.


Please orient your device to the portrait position to return to the site