If you are at high-risk for developing pancreatic cancer, talk to your doctor about your concerns. Some physicians are unaware of the genetic and hereditary risk factors for pancreatic cancer. Immunovia, Inc. has developed an educational brochure for healthcare professionals, which may be a helpful resource for you to give to your physician, as well as this flyer with helpful talking points for the discussion.
Would you like us to contact your healthcare provider about the IMMray® PanCan-d test? If so, please enter your healthcare provider’s information below.
Note: This form is applicable to providers in the United States only. The IMMray PanCan-d test is currently available in most U.S. states, but it is not yet available to residents in California, Maryland, New York, Pennsylvania, or Rhode Island. If you are located outside of the U.S., please email email@example.com for more information.
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Provider phone number
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Would you like us to mention you by name when we speak with your healthcare provider? If so, please enter your name below.
If you would like the Customer Support team to follow up with you directly, please enter your phone or email address below.
By submitting this form, I agree to Immunovia, Inc. contacting my healthcare provider about the IMMray PanCan-d test using the information provided.
You may also want to take the IMMray PanCan-d test requisition to your appointment. If your physician agrees that you are at high risk for pancreatic cancer and should be tested, he or she can sign the form during your appointment and submit it to Immunovia, Inc. to begin the testing process.
Individuals at high risk for pancreatic cancer should be tested as part of their regular pancreatic cancer surveillance program. Frequency of testing is up to the patient and the ordering physician.