Request a Representative

Your local representative can provide you with more information about HyperTET. Submit a request below. All fields required.

All fields are required unless otherwise stated

Your details

First Name

Last Name

Occupation

Hospital/Facility or Corporation Name

ZIP Code

Your request

I would like information on:

* Check all that apply

HyperTET® (tetanus immune globulin [human])

Patient assistance program

Ordering and reimbursement

Other

How would you like to be contacted?

I would like to be contacted by:

Phone call