Get Referrals To The Genentech Access To Care Foundation (gatcf ...

This guide provides detailed instructions for completing the Referrals To The Genentech Access To Care Foundation (GATCF) form online. Follow these steps to ensure your submission is accurate and timely.

Follow the steps to complete the form successfully.

1. Press the ‘Get Form’ button to obtain the form and launch it for editing.
2. Enter the date of service for each infusion or injection provided. Make sure to fill in all the required fields with the correct information.
3. Fill in the amount infused or injected for each date listed. This information is crucial for accurate documentation.
4. In the section that requires you to print the patient's name, ensure that you accurately fill in the full name as it appears on official records.
5. Provide the patient's date of birth to confirm their identity.
6. An authorized healthcare professional (HCP) must sign the document. Ensure that the signature is from the person accountable for the patient's care.
7. Include the date on which the healthcare professional signs the form.
8. If applicable, indicate the next scheduled infusion or injection date.
9. Review all entered information for accuracy and completeness before proceeding.
10. Once completed, save changes, and choose to download, print, or share the form as required.

Begin completing your documents online now.