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Get Shire Cares 2020-2026
How it works
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Open form follow the instructions
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Easily sign the form with your finger
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How to fill out the Shire Cares online
The Shire Cares Patient Assistance & Support Program provides guidance to individuals needing help affording their Shire medicines. This document offers a step-by-step approach to assist you in filling out the Shire Cares application form online.
Follow the steps to complete your application form effectively.
- Press the ‘Get Form’ button to access the application form and open it for editing.
- Begin with Section 1, where your treating doctor's information, including their name, license numbers, and facility details, must be provided. Ensure all fields are completed accurately.
- In Section 2, input the prescription information. This requires the diagnosis, prescribed medication, dosage, and shipping preference. Ensure this section is filled out correctly without additional prescriptions needed.
- Proceed to Section 3 for your personal information. Include your name, date of birth, contact information, and ensure you indicate your citizenship status.
- Move to Section 4 to provide your household financial information. Clearly list the number of people in your household and your total income. Be prepared to attach proof of income as specified.
- In Section 5, answer questions regarding your insurance coverage. Fill in details about your insurance policy and attach copies of your insurance card.
- Complete Section 6 by providing your authorization for Shire Pharmaceuticals to access necessary records. Verify your information is accurate and sign the section. If unable to sign, ensure a representative signs and states their authority.
- Once all sections are filled, review the form to ensure completeness. Save your changes and consider downloading, printing, or sharing the form as needed.
Complete your application online to access support from Shire Cares.
If you're asking about patient assistance for a specific condition or medication, Shire Cares is a great starting point. This program helps connect patients with resources they need to manage their treatment costs. To explore options related to your particular needs, I recommend visiting the Shire Cares website or reaching out to their support team for personalized assistance.