Opt in to the Kyowa Kirin HCP Finder

Opt In to the Kyowa Kirin
HCP Finder

If you are a Healthcare Professional (HCP) who has experience managing XLH patients and practices in the US, please fill out the form below to be added to Kyowa Kirin, Inc.'s location-based HCP Finder.

The location-based HCP Finder is a tool to help patients and caregivers connect with qualified HCPs who can help manage XLH.

Please select an option to proceed.

I am an HCP submitting this information for myself.

I am authorized to submit this information on behalf of an HCP.

HCP: healthcare professional.

Fill out the form below

Please populate the fields below with the required information.

(* Required fields)

HCP Details

The following fields will not be displayed on the HCP Finder and are for internal communication and validation only.

NPI*

Incorrect? Click here to go back.

HCP email*

The following fields will be displayed on the HCP Finder.

First name*

Last name*

Professional designation*

Specialty*

What type of patients do you typically manage?*

Practice Details

The following fields will be displayed on the HCP Finder.

Primary practice name*

Primary practice website (optional)

Primary practice address*

City*

State*

ZIP code*

E.g., 12345

Phone*

E.g., 999-999-9999

Telehealth services are offered at this practice

Authorization

I authorize the inclusion of my contact information in Kyowa Kirin’s HCP Finder to reside on Kyowa Kirin disease education websites at a future date.*

The Kyowa Kirin HCP Finder will offer the user the opportunity to locate and contact an HCP who specializes in managing XLH.
The data collected in connection with the HCP Finder is for informational purposes only.
No fees or other remuneration have been or will be exchanged for an HCP's inclusion in this database.
Inclusion of HCPs in this database will be based on opt in approval by the HCP or authorized personnel.
Kyowa Kirin is not affiliated with, and inclusion in this database does not represent an endorsement of, recommendation for, or referral to, the HCP listed in this database. Likewise, participating HCPs do not necessarily endorse the use of any Kyowa Kirin products.

I'd like to sign up for communications from Kyowa Kirin, Inc.

You are required to be 18 years of age or older to receive emails from XLHLinkHCP.com.
By clicking submit, you agree that Kyowa Kirin, or companies acting on its behalf, may send you educational materials and updates about XLHLinkHCP.com, Kyowa Kirin products, clinical trials, programs, and other information that may be of interest to you.
You may opt out at any time, instructions for which will be included in each email you receive.
You understand that Kyowa Kirin, and companies acting on its behalf, will not sell or rent your personally identifiable information, and will only use your personal information as described in the Kyowa Kirin Privacy Policy and Terms of Use.

HCP: healthcare professional; NPI: National Provider Identifier.