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Acne, ACCUTANE and You
About Informed Consent
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Please sign a consent form before taking ACCUTANE
The consent form is a policy requirement for taking ACCUTANE. Signing the consent form, or having your parent or guardian sign it on your behalf, tells your doctor that you understand all the information you have received from your doctor about ACCUTANE.

If you are male, you must read and sign Part I of the form. If you are female, you must read and sign Part I and Part II of the form.

Your doctor should explain all the information in the consent form to you, and you should also read it over carefully before you sign it. If there is anything you don’t understand in the consent form, ask your doctor about it before you sign the form.

When you have signed the form, give one copy to your doctor to keep in your medical file and keep one copy for yourself.

Download ACCUTANE Informed Consent form

You’ll need Adobe Reader to view or print this document. If you don’t already have it on your computer, you can download it for free.

Questions or concerns about taking ACCUTANE?
Talk to your doctor or call the Roche Drug Information Department (toll-free) 1-888-762-4388.
Accutane
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