Join My Merck Support today

Tell us about yourself so we can help tailor support to you. Complete this short form to get started.

Tell us about yourself

I am a*(Required)

Patient

Care partner

I am 18 years or older*

First name*(Required)

Last name*(Required)

Next treatment date / Next fill date*(Required)

Email address* Confirm email address*

ZIP code*(Required)

*Required

To get more tailored support, select the options below

Dedicated Live Support

Once you provide your telephone number, we’ll schedule a Welcome Call with your My Merck Support team member. Support is available Monday–Friday, 8am–8pm ET, in more than 200 languages.

Phone number*(Required)

Is this a mobile phone?*(Required)

Yes

Please select the best time to reach you*(Required)

A dedicated My Merck Support team member will call you within 2 business days of signing up (Monday–Friday).

Mobile Authorization

I agree that Merck & Co., Inc., its affiliates, and vendors working on behalf of Merck, including Virtual Marketing Strategies, Inc. (d/b/a Momentum Life Sciences, Inc.), The Hibbert Company, Inc., and Authenticx, Inc. and their vendors (collectively, “Merck”) may send me communications about resources and services related to my enrollment in the My Merck Support Program via telephone call and text message. Message and data rates may apply. At any time, I understand that I may request to stop further telephone calls or text messages by following the opt-out directions provided during those communications. I UNDERSTAND THAT THESE COMMUNICATIONS MAY USE PRE-RECORDED/ARTIFICIAL VOICE MESSAGES AND/OR AN AUTOMATED SYSTEM AND THAT I DO NOT NEED TO AGREE TO RECEIVE CALLS/TEXT MESSAGES AS A CONDITION OF PURCHASING OR RECEIVING ANY PRODUCTS OR SERVICES FROM MERCK.

I consent to the terms above and have provided my mobile phone number.

I do not consent to the terms above.

Starter Kit

Provide your mailing address below to get your free My Merck Support Starter Kit by mail. This resource can help you get started and stay organized during treatment. This kit will also include a cookbook to help you with meal and recipe ideas.

Mailing address*(Required)

Mailing address continued

City*(Required)

State*(Required)

Thank you for completing this form. Click “Continue” to review and confirm your participation in the program.

One last step to complete your enrollment

Authorization and Agreement

The purpose of this Authorization is to allow Merck & Co., Inc., its affiliates, and vendors working on behalf of Merck, including Virtual Marketing Strategies, Inc. (d/b/a Momentum Life Sciences, Inc.), The Hibbert Company, Inc., and Authenticx, Inc. and their vendors (collectively, “Merck”), to collect, use, and disclose to vendors and third parties your personal information, such as name, email, address, and telephone number, as well as health information, such as prior and current mental and physical health conditions, diagnoses, and treatment information (collectively, “Your Information”) as identified in this Authorization.

By executing this Authorization, you, or a legally authorized representative on your behalf (collectively, “You” or “Your”), agree that You have read and understand the following:

By signing below, You are permitting Merck to collect, use, and disclose to vendors and third parties Your Information (1) so that you can join the My Merck Support Program; (2) to verify your eligibility to join the My Merck Support Program; (3) to communicate with you via U.S. postal mail, telephone, and email about program materials and the My Merck Support Program; (4) to ensure compliance with laws, Merck policies, and rules of the My Merck Support Program; (5) to allow Merck to analyze the My Merck Support Program, including the customer support services provided, to evaluate, improve, and better provide the services, including through AI-assisted technologies; and (6) to send you educational resources about the My Merck Support Program, treatment information, and other materials created by the My Merck Support Program.
This Authorization is completely voluntary. However, if You do not sign the Authorization, Merck will not be able to have you join in the My Merck Support Program or provide the resources developed for that program.
This Authorization will have no impact on your eligibility for treatments, payments, enrollments, or eligibilities for government or private insurance benefits.
You may withdraw this Authorization at any time by calling 1-888-776-8364 or by visiting mymercksupportteam.com.
Unless You withdraw this Authorization sooner, it will be valid until (i) 5 years from execution; (ii) you request to be removed from the My Merck Support program; or (iii) as otherwise specified by applicable law, whichever is shorter.
If you revoke your Authorization by opting out, it will take effect as soon as your revocation notice is received but will not invalidate uses or disclosures of Your Information by Merck made in reliance on the Authorization prior to our receipt of your notice of revocation.
You are entitled to a copy of this Authorization once you have signed it. You may request a copy of this Authorization by calling 1-888-776-8364.

For more information on how we use Your Information, please visit msdprivacy.com/us/en/supp-notice/. For information on how we use Your health-related Information, please visit msdprivacy.com/us/en/chd-policy/.

I have read and consent to the collection of my Information for the purposes described above.

I consent to Merck disclosing my Information for the purposes described above.

By signing below, you, or a legally authorized representative, acknowledge that you have read and agree with the Authorization terms above.

Type your full name*(Required)

Date*

*If you do not consent to sharing with our partners, services cannot be provided.

My Merck Support is brought to you by Merck. This site is not a substitute for professional medical advice. Your doctor should continue to be your main source of information about your medical condition and treatment.