NovoPen® Echo® Request Form
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This form enables Canadian Pharmacy Healthcare Professionals to request NovoPen® Echo® devices from Novo Nordisk Canada Inc.
This form is to be used to submit NovoPen® Echo® device requests to Novo Nordisk Canada Inc. and does not constitute an order. All order fulfilment is at the discretion of Novo Nordisk Canada Inc.
Once received at the pharmacy, NovoPen® Echo® devices are to be distributed to the patients who have requested them at no cost. NovoPen® Echo® devices are NOT FOR RESALE.
This program may change or end at at the discretion of Novo Nordisk.
Please direct any questions to:
Novo Nordisk Canada Inc.
101-2476 Argentia Road
Mississauga, Ontario L5N 6M1
Phone: +1 905 629 4222
Phone (Toll-free): +1 800 465 4334
Fax: +1 905 629 8662
Fax (Toll-free): +1 844 465 2225
www.novonordisk.ca