For Healthcare Professionals
Login to the Nplate
®
NEXUS Program
For your convenience, all our forms can be found below. Take a moment and bookmark
this page for future visits.
Healthcare Professional
Nplate
®
NEXUS Program Healthcare Provider Enrollment Form
Nplate
®
NEXUS Institution Enrollment Form
The FDA Safety Information and Adverse Event Reporting Program - MedWatch Form
Nplate
®
NEXUS Healthcare Professional Brochure
Nplate
®
NEXUS Program Discontinuation/Post-Discontinuation Follow-up Form
Nplate
®
NEXUS Program: Bone Marrow Reticulin/Bone Marrow Fibrosis Form
Nplate
®
NEXUS Program: Hematological Malignancy/MDS Form
Nplate
®
NEXUS Program: Medication Errors Associated with Serious Outcomes Form
Nplate
®
NEXUS Program: Worsened Thrombocytopenia after Cessation of Treatment with Nplate
®
Form
Nplate
®
NEXUS Program: Thrombotic/Thromboembolic Complication Form
Patient
Nexus
®
Patient Enrollment Form
Nexus
®
Patient Brochure
Nplate
®
NEXUS Safety Questionnaire
Nexus
®
Patient Baseline Data Form
Nplate
®
NEXUS Program Patient Medication Guide
The Nplate
®
NEXUS Program Introductory Letter (Spanish Version)
The Nplate
®
NEXUS Program Patient Enrollment Form (Spanish Version)
The Nplate
®
NEXUS Program Patient Brochure (Spanish Version)
Nplate
®
NEXUS Program Patient Medication Guide (Spanish Version)