MyBONIVA(R)

Register for MyBONIVA

For women taking or considering once-monthly BONIVA for the treatment or prevention of postmenopausal osteoporosis, simply complete this form and click "Register" below. You can unsubscribe at any time.

Yes, I certify that I am over 18 years of age and would like to join MyBONIVA. One free trial per person.

E-mail Address

Password (6-10 characters)

Confirm Password

First Name

Last Name

Street Address

Apt/Floor/Suite (optional)

City

State
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ZIP or Postal Code

Please take a moment to share some optional information with us so we can customize your profile.

Have you been diagnosed with osteoporosis or osteopenia (thinning of the bones)?
YesNo

Genentech understands that your privacy is important. Please note that by providing your name, address, or other information, you are giving Genentech and companies working with us permission to communicate with you via traditional mail, e-mail, and/or telephone about postmenopausal osteoporosis and medicines that treat postmenopausal osteoporosis. We will not sell or transfer your name, address, or other personally identifiable information about you to any party for its own marketing use. To view the Genentech privacy policy, please visit www.boniva.com/privacy.htm.