Complete the contact form below to register your interest now

Thank you for your interest in BlossoMS, a pregnancy registry for women with MS who have received either Vumerity® (diroximel fumarate), or no MS therapy, at any time from 2 weeks after the first day of the last menstrual period.

Fill out the contact form below or call 1-(833)-569-2635 to speak with a registry representative to determine your (or your patient’s) eligibility to participate in the registry.

* Indicates required field

I am a:
Patient
Healthcare Provider

About the healthcare provider (HCP)

Please provide us with the following information so that we may contact your patient.

+1
Please enter correct phone number format.

By checking the boxes below, I confirm that:

About the patient
Patient region and preferences
Patient contact information
+1
Please enter correct phone number format.
+1
Please enter correct alternate number format.