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How to fill out the 18002772254 online
Filling out the 18002772254 form is an essential step for users seeking assistance from the Novartis Patient Assistance Foundation. This guide will provide detailed, step-by-step instructions to help you successfully complete the application online.
Follow the steps to complete the 18002772254 form accurately.
- Click ‘Get Form’ button to obtain the form and open it in the editor.
- Carefully fill out the Patient Section on page 2. This includes providing your personal information such as name, address, and contact details. Be sure to answer the questions regarding your residency, income sources, and any disabilities you may have.
- Attach copies of all required financial documentation. This includes your household’s most recent year tax returns or other relevant documents that support your financial situation.
- Have your doctor complete and sign the Prescription Section on page 3, ensuring all fields are correctly filled out with the necessary information regarding your prescribed medications.
- Once the form is fully completed and signed, mail or fax it along with all documentation to the address or fax number provided at the top of the application. Confirm your submission method matches the requirements for your situation.
Start filling out the 18002772254 form online today to access the assistance you need.
If you are experiencing financial hardship and have limited or no prescription coverage, then you may be eligible to receive Novartis medications for free from the Novartis Patient Assistance Foundation, an independent nonprofit organization. To learn more, call 1-800-277-2254 or visit .PAP.Novartis.com.
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