Ozurdex Enrollment Form - Web patient enrollment form *required information. Web complete the enrollment form. Find and access programs, support and resources for. Web see full program terms, conditions, and eligibility criteria on card. Upload to the allergan eyecue® portal or fax to 1‑866‑676‑4069.
Upload to the allergan eyecue® portal or fax to 1‑866‑676‑4069. Web complete the enrollment form. Web patient enrollment form *required information. Find and access programs, support and resources for. Web see full program terms, conditions, and eligibility criteria on card.