Request demonstration pens
- Demonstration Pen: For demonstration and training only. Not for patients or injection into humans. Does not contain medicine. Only to be used by a health care professional. Needles are not included.
- Demonstration pen kit requests may only be submitted by health care professionals who are licensed to prescribe Mounjaro.
- Please complete and submit the demonstration pen kit request form below to begin.
- You may submit a demonstration pen kit request every 30 days.
Fields with (*) are mandatory. Name must match NPI Number.
Starting and continuing once-weekly Mounjaro*
Start the experience
Starting dose (for 4 weeks)
Continue the experience
For at least 4 weeks