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Submitted URL: https://restasismdinfo.ca/
Effective URL: https://www.restasis.ca/en/home-MULTI?utm_medium=qr-code&utm_campaign=restasismd&check_logged_in=1
Submission: On July 24 via api from US — Scanned from CA
Effective URL: https://www.restasis.ca/en/home-MULTI?utm_medium=qr-code&utm_campaign=restasismd&check_logged_in=1
Submission: On July 24 via api from US — Scanned from CA
Form analysis
1 forms found in the DOMName: myform — GET
<form name="myform" id="reminderForm" action="" method="GET">
<label for="dateReminder" class="label-required">When did your physician tell you to take SKYRIZI?</label>
<div> <input type="date" name="dateReminder" id="dateReminder" required="required" class="py-1 pl-2 pr-1 border rounded w-100 border rounded w-100"> </div><br>
<input type="hidden" id="title" name="title" value="SKYRIZI medication reminder">
<input type="hidden" id="description" name="description" value="">
<div class="form-group">
<label for="time" class="label-required">What time would you like to be reminded?</label>
<div class="time-wrap d-flex justify-content-center m-auto flex-column flex-sm-row">
<div class="time-fields-container d-flex border rounded py-1 px-2 w-100">
<select data-val="true" class="border-0 p-0" data-val-required="Please make a selection." id="heureReminder" name="heureReminder" required="required">
<option>01</option>
<option>02</option>
<option>03</option>
<option>04</option>
<option>05</option>
<option>06</option>
<option>07</option>
<option selected="selected">08</option>
<option>09</option>
<option>10</option>
<option>11</option>
<option value="0">12</option>
</select>: <select id="minuteReminder" class="border-0 p-0" name="minuteReminder" required="required">
<option selected="selected">00</option>
<option>15</option>
<option>30</option>
<option>45</option>
</select>
</div>
<div class="d-flex ml-sm-2 w-100 justify-content-center mt-2 mt-sm-0">
<div class="mx-1">
<input type="radio" name="momentReminder" id="am" value="0" required="" checked=""> <label for="am" class="btn border-primary bg-cerulean-lite mt-2 mt-sm-0">AM</label>
</div>
<div>
<input type="radio" name="momentReminder" id="pm" value="12" required=""> <label for="pm" class="btn border-primary bg-cerulean-lite mt-2 mt-sm-0">PM</label>
</div>
</div>
</div>
</div>
<div class="row mx-auto submission-section flex-sm-nowrap mb-6 justify-content-center">
<div class="col-12 col-sm-4">
<input type="reset" value="Back" name="Reset" class="btn border-primary mt-2 ml-auto mr-0">
</div>
<div class="border-right d-none d-sm-block"></div>
<div class="col-12 col-sm-4">
<input type="submit" id="submitCal" data-application="" value="Add to calendar" name="button" class="btn btn-primary mt-2">
</div>
</div>
<div id="reminderFormErrorMessage" style="display:none;" class="row mx-auto submission-section flex-sm-nowrap mb-6 justify-content-center">
<div class="col-12 col-sm-12">
<p class="alert alert-error">The provided date must be valid.</p>
</div>
</div>
</form>
Text Content
Skip to main content * en * fr Contact us Print page Search * en * fr Contact us Print page * Home * Financial Assistance Program * Aqueous Deficient Dry Eye / RESTASIS MultiDose * How to Use BROWSER UPDATE To provide the best user experience possible, please update your browser. WARNING MESSAGE You must enter a valid DIN to enter the site. WARNING MESSAGE That is not a valid DIN. Please try again. WELCOME TO THE RESTASIS MULTIDOSE PATIENT SUPPORT SITE HERE, YOU’LL FIND INFORMATION AND RESOURCES TO HELP YOU UNDERSTAND YOUR CONDITION, AND SUPPORT YOU ALONG YOUR RESTASIS MULTIDOSE TREATMENT JOURNEY. RESTASIS MULTIDOSE FINANCIAL ASSISTANCE PROGRAM IF YOU REQUIRE FINANCIAL ASSISTANCE FOR YOUR RESTASIS MULTIDOSE PRESCRIPTION, PLEASE CLICK HERE. † Total cost includes drug acquisition cost, mark-up, and pharmacy dispensing fee. The financial assistance program will cover a portion of these costs. Patients may still be required to pay some costs out of pocket. RESTASIS MULTIDOSE AND AQUEOUS DRY EYE DISEASE. Learn more about RESTASIS MultiDose Explore GET IN TOUCH WITH US! GET IN TOUCH WITH US! Phone icon RESTASIS MultiDose and its design are registered trademarks of AbbVie Corporation. 2024 AbbVie. All rights reserved. CA-RMD-220016 The information contained in this site is provided for educational purposes only and is not intended to be a substitute for your doctor’s advice. Should you have any additional questions about your treatment or condition, please talk to your doctor. * Privacy Policy * Terms of Use * Cookie Notice With the recent news about COVID-19, here is what we are doing to ensure you continue to have access to your medication and AbbVie Care services. We are closely monitoring our manufacturing and supply chain resources around the world, and we do not anticipate any disruption to our medicine supply as a result of COVID-19. We are also working with our partners to ensure that services for AbbVie Care members are not disrupted. You are encouraged to follow your physician’s guidance on taking your medication, and you should not stop taking any medication without consulting with your health care team beforehand. Should you have any questions about your medication, please contact your physician directly. For assistance accessing your medication, or if you have questions about how AbbVie Care can help, please contact us. You can also consult the Health Canada website. During this time of uncertainty, you can count on us to address any concerns you may have around your continued access to your medication. We’re here to support you any way we can. Thank you, Your AbbVie Care team I understand © AbbVie Corporation REMEMBERING TO TAKE YOUR SKYRIZI Calenda icon We know that sticking to a new treatment routine can sometimes be challenging, but we are here to help! Customize your reminders: When did your physician tell you to take SKYRIZI? What time would you like to be reminded? 01 02 03 04 05 06 07 08 09 10 11 12 : 00 15 30 45 AM PM The provided date must be valid. × You are about to leave an AbbVie Canada site, a site maintained by AbbVie Corporation. This link is provided for your convenience only. AbbVie Corporation takes no responsibility for the content of any site maintained by any third party and makes no representation as to the accuracy or completeness of any information contained on this or any subsequent link. Do you wish to leave this site? YesNo WE VALUE YOUR PRIVACY This site uses cookies and related technologies, as described in our privacy policy, for purposes that may include site operation, analytics, enhanced user experience, or advertising. You may choose to consent to our use of these technologies, or manage your own preferences. MANAGE CHOICES ACCEPT ALL REJECT ALL Privacy Policy Powered by: