This portal is only intended for use by UK healthcare professionals who work within pulmonary hypertension therapy area at a dedicated or prescribing shared care centre.
This service for post-prescriptive patients is fully supported and funded by MSD.

Home Monitoring Pack Portal

Use this form to send Home Monitoring Packs directly to patients from the Home Monitoring Pack support line (E4H).

*Mandatory fields

Please read this statement to the patient:

“I understand my personal information, including my full name, home address and contact telephone number which I shared with the healthcare professional are confidential and will be shared with Merck Sharp & Dohme (UK) Limited (MSD) to provide the Home Monitoring Service. MSD will not store this information and will send this directly to Events4Healthcare LTD to administer the delivery and collection of Home Monitoring Packs. I understand that I can request access to my personal data, make corrections or request the information to be deleted. A copy of the MSD privacy notice will be included in the Home Monitoring Pack where you will find additional information on how MSD and E4H will manage your personal data.”

“I understand that my name, address and contact number will be shared with the courier responsible for delivering items; however no personal medical information will be shared.”

Statement disclaimer*

* By ticking this box I confirm that I have read the above statement to the patient, that the patient has understood and agreed to the statement.

Loan agreement disclaimer*

* By ticking this box I confirm that I have read the loan agreement to the patient

Patient name and surname*

Telephone*

Home address*

Patient diagnosis*

Centre*

Healthcare professional name*

Code*

This is the 6-digit code provided to you by MSD

Clicking ‘Confirm’ will send an email confirmation to the E4H support line. E4H will print a copy to be put into the HMP sent to the patient and email a copy to the PH centre.

Comments

This field is for validation purposes and should be left unchanged.

If you have any questions please contact Events4Healthcare on 0800 012 6055 or HMP@e4h.co.uk

This record is prepared as three copies (1) for E4H – The Home Monitoring Pack Support Line, (2) the healthcare professional, (3) and the patient.

Home Monitoring Pack Portal

Use this form to send Home Monitoring Packs directly to patients from the Home Monitoring Pack support line (E4H).

Please read this statement to the patient:

Welcome to the Home Monitoring Pack Portal