Log On  

GENCAN PHONE: 1-866-501-3338
GENCAN FAX: 1-800-497-9592

If you are a Healthcare Provider and would like to initiate Gen-clozapine therapy,
please complete a Patient Registration Form and fax it to GENCAN.

Once Registered, you will have access to the GenCAN™ database, which will assist you in the Monitoring
of your Patients.  CLICK on one of the buttons below to download.


Patient Registration Form
Proxy User Registration Form
Blood Reporting Form

     

Patient Registration Form is used for:

□         Registering a Patient  - new or switched from another brand of clozapine

□         Modifying any information for a Patient who is registered with GenCAN™

□         Pharmacist Registration (or modifying an existing Pharmacist’s Information)

□         Physician Registration (or modifying an existing Physician’s Information)

Proxy User Form is used for:

□         Registering a Proxy User who requires access to the GenCAN™ database



Instructions for downloading:

Select the appropriate form and save the pdf file to your computer. Once you have printed and completed the form, return VIA fax to 1-800-497-9592.

Adobe Acrobat is required to view and print these files. If you do not have Acrobat installed on your computer, please click the link below to download and install the software.



Click here to return to the log-in page

GenCAN & Design® is a registered trademark of Mylan Pharmaceuticals ULC, a Viatris company.
VIATRIS and VIATRIS & Design are trademarks of Mylan Inc., used under permission by
Mylan Pharmaceuticals ULC, a Viatris company.
Copyright © 2024 UBC Product Support Center.
Terms of Use  | Privacy Policy
CLZ-2023-0051E-OC2023