•Eligible patients may be able to receive medication at no cost
•HCP should fax completed application form and any supporting documentation to: 18002166857
•HCP and Patients can also enroll online at: https://advancingaccessconsent.iassist.com/
•Proof of residency and income must be provided
•An Advancing Access reimbursement counselor will notify the requestor about the patient’s coverage and benefits, alternate funding options and/or qualification for the PAP
•Patients who meet the eligibility criteria for the PAP will be prequalified for the program
•The program will notify the patient and the prescriber of the prequalified status
•Call 8002262056 Monday through Friday, 9 am to 8 pm EST for more information