Sample Request Forms
YUPELRI(revefenacin) package

YUPELRI® (revefenacin) inhalation solution

YUPELRI Sample Request Form

If you’re a healthcare professional, you may be eligible to receive samples of YUPELRI. To make a request, download and complete the YUPELRI Sample Request form, then fax it to the attention of Viatris’ Sample Department at 304-285-6418.

Sample Request Form