Use the form below to sign up to receive helpful information, tips, and resources designed for people who have been prescribed TECENTRIQ immunotherapy.

*Indicates a required field

Which option best describes you?*

Thank you for your interest in TECENTRIQ On Your Side. At this time, TECENTRIQ On Your Side is only designed for people who have been prescribed or are currently on TECENTRIQ.

We understand how important it is to find support when you or someone you love has been diagnosed with cancer. There are many national organizations that can provide valuable resources and information to cancer patients and their family. Learn more

Please fill in the form below to sign up for TECENTRIQ On Your Side.

Select

You must be 18 years or older to sign up.

Select
  • Alaska
  • Alabama
  • Arkansas
  • American Samoa
  • Arizona
  • California
  • Colorado
  • Connecticut
  • District Of Columbia
  • Delaware
  • Florida
  • Georgia
  • Guam
  • Hawaii
  • Iowa
  • Idaho
  • Illinois
  • Indiana
  • Kansas
  • Kentucky
  • Louisiana
  • Massachusetts
  • Maryland
  • Maine
  • Marshall Islands
  • Michigan
  • Minnesota
  • Missouri
  • Mississippi
  • Montana
  • North Carolina
  • North Dakota
  • Nebraska
  • New Hampshire
  • New Jersey
  • New Mexico
  • Nevada
  • New York
  • Ohio
  • Oklahoma
  • Oregon
  • Pennsylvania
  • Puerto Rico
  • Palau
  • Rhode Island
  • South Carolina
  • South Dakota
  • Tennessee
  • Texas
  • Utah
  • Virginia
  • Virgin Islands
  • Vermont
  • Washington
  • Wisconsin
  • West Virginia
  • Wyoming

By providing your information, you agree to allow Genentech and its agents to collect the information provided and to be contacted by Genentech and its agents using this information in the future. Furthermore, you are agreeing that Genentech and its agents may contact you by phone, email, or mail, and that such electronic or other written communications may include information regarding your health within them. Genentech will not sell, rent, or otherwise distribute your name and any personally identifiable information outside of Genentech and its agents. Genentech will only use your information in accordance with the Genentech Privacy Policy.

Please refer to our Terms & Conditions. By signing up for this site, you are indicating that you want to receive information from Genentech on TECENTRIQ, as well as product information about specific treatments.

Registration Confirmation

Thank you! Your information has been received and you should receive your Welcome Kit in the next few weeks.

We look forward to sending you more information in the near future.

Click here for additional patient and caregiver resources.