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  • Abbvie Sample Form

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PATIENT ASSISTANCE ATTESTATION FOR () PLEASE COMPLETE ALL SECTIONS, SIGN, AND FAX THIS FORM TO 1-866-250-2803 OR MAIL TO: ABBVIE PATIENT ASSISTANCE FOUNDATION D-617927, AP5 NE 1 N. WAUKEGAN RD NORTH.

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Fax: 1-866-898-1473 Please contact us at 1-800-222-6885 Monday through Friday for additional assistance. This program is part of the AbbVie Patient Assistance Foundation, a separate legal entity from AbbVie.

Log into our website with your User Name and Password to check your Dashboard. Here you will see any notifications that we have sent you as well as the status of your application and order history. We may also send you an email or text message based on your preferences chosen in your Profile.

APPLICATION FOR ® () myAbbVie Assist provides free medicine to qualifying patients. We review all applications on a case-by-case basis. Participation in our program is free; we do not collect any fees from people seeking our assistance.

Once we receive all the information needed, we usually review applications within two business days. After that, we'll contact you and your health care provider to let you know if you qualify.

myAbbVie Assist We believe that people who need our medicines should be able to get them. That's why myAbbVie Assist provides free AbbVie medicine to qualifying patients. If you have any questions, visit the FAQs or call us at 1-800-222-6885. AbbVie is committed to helping patients get the medicines they need.

AbbVie Patient Access Support offers various affordability and access programs: PATIENT ASSISTANCE PROGRAM (PAP): myAbbVie Assist provides free medicine to qualifying patients. SAVINGS CARD: Available to patients with commercial prescription insurance coverage who meet eligibility criteria.

myAbbVie Assist provides free medicine to qualifying patients. If you are uninsured or have limited insurance coverage, you may be eligible to receive prescribed AbbVie medication at no cost from our Program.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232