Receive POLIVY information from your Genentech representative

Please remember: This feature is intended for US healthcare professionals only.

Complete this form below if you are a healthcare professional and would like to contact a Genentech representative for more information about POLIVY.

Personal Information (*Indicates a required field.)

  • Clinical Coordinator
  • Clinical Nurse Specialist
  • Homecare Nurse
  • Nurse
  • Nurse Practitioner
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  • Researcher
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  • Medical Oncology
  • Pulmonary Critical Care Medicine
  • Pulmonary Disease
  • Radiation Oncology
  • Surgical Oncology
  • Other
  • Dr
  • Mr
  • Mrs
  • Ms

When you submit this form, your contact information will be sent to the Genentech representative for your area. Your representative will then contact you directly, either via email and/or phone. Your personal information will not be used for any other purpose than for a representative to respond to your information request.

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