Resources

Access helpful resources for your
patients and practice.

Letters and Forms

Sample Letter of Medical Necessity

Sample Letter of Appeals

FDA Approval Letter

Patient Consent Form

UDENYCA ^® Prescribing Information

Program Enrollment Form

PAP Enrollment Form

Product Replacement Program Brochure

Virtual Debit Card Fax Request

Product Replacement Form

Patient Assistance Request Form

Have questions?

For questions regarding Coherus Solutions^TM resources, call 1-844-4-UDENYCA / 1-844-483-3692.

Contact Us

Tel: 1-844-4-UDENYCA
(1-844-483-3692)
Fax 1-877-226-6370

Coherus.com | UDENYCA.com

Contact Us

Tel: 1-844-483-3692
Fax 1-877-226-6370

Coherus.com | UDENYCA.com | LOQTORZI.com | YUSIMRY.com

Coherus.com

Coherus reserves the right to terminate the Coherus Solutions™ program without any notice at any time
Coherus Solutions, UDENYCA Solutions, and LOQTORZI Solutions are trademarks and UDENYCA and LOQTORZI are registered trademarks of Coherus BioSciences, Inc.. All other
trademarks are property of their respective owners. ©2024 Coherus BioSciences, Inc. All rights reserved.US-CMB-0043 06/24