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Register for the BYDUREON
Patient Support Program

Whether you are considering treatment or you are already on BYDUREON, we’re here to help. Just fill out the form below and we'll send you important information that may help you throughout your journey.

If you're considering BYDUREON, you'll receive a FREE Information Kit, including a discussion guide, that can help you and your doctor decide if BYDUREON is right for you. (Some restrictions apply.)

If you're about to start or are already on BYDUREON, you'll receive reminders when to administer BYDUREON and other useful tools to help you make the most of your treatment program.

It's FREE, so sign up today or call us toll-free at

1-844-9BYDPEN (1-844-929-3736).

By completing this form, you will be enrolled to receive information related to your condition, including treatment information.

AstraZeneca respects your personal health information. The information you provide may be used to send you health-related materials and to develop products, services, and programs. AstraZeneca, or third parties working on our behalf, will not sell or rent personal health information. If in the future you no longer want to receive these materials, please call 1-877-700-7365. Please visit www.azprivacynotice.com to review our Privacy Notice.

Sample Basic Survey

Register*Indicates required field

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By providing your date of birth, you verify that you are at least 18 years of age.

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 Considering this medication?
 About to start using this medication?
 Currently using this medication?
 
 

Dosing Reminders

You can also sign up to receive reminders to help you remember which day you use BYDUREON.

 
 Monday
 Tuesday
 Wednesday
 Thursday
 Friday
 Saturday
 Sunday
 Yes, I would like to receive information in the future about all AstraZeneca products, programs, and services that may be of interest to me.
 Yes, I would be willing to be contacted on occasion to participate in market research studies sponsored by AstraZeneca.
 Yes, I would be willing to share my experience as a patient using BYDUREON with an AstraZeneca representative.