Fill in the form to place your order for ZOLADEX® (goserelin acetate implant). To participate in the program, you'll need to have a contract with AstraZeneca.
Quantity of ZOLADEX® (goserelin acetate implant)
We are asking for your SLN number to verify your identity. This information will be kept confidential and will only be used to confirm that the SLN number entered matches the number on record.Please enter a valid SLN number into this field
You need to register in the ZOLADEX Direct Purchase Program to place an order. If you do not have an account number please download the contract and follow the instructions to register. If you have forgotten your account number, please call 1-800-400-4140.Please enter a valid account number
Please enter a valid phone number
You are encouraged to report negative side effects of prescription drugs to the FDA.
Visit www.FDA.gov/medwatch or call 1-800-FDA-1088.