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Aviatrix Patient Assistance Program (PAP) Application | Phone: 8884175780* | Fax: 8774277290 | General Hours: MF, 8AM to 5PM EST* |Please complete application in full, sign and date, then fax to:

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How to fill out viatris patient assistance program

01

Visit the Viatris patient assistance program website

02

Download and fill out the application form

03

Provide all required documentation such as proof of income, prescription information, and a signed healthcare provider statement

04

Submit the completed application and documentation either online or by mail

05

Wait for approval and if approved, start receiving assistance

Who needs viatris patient assistance program?

01

Individuals who cannot afford their prescription medications

02

Uninsured individuals

03

Underinsured individuals with high out-of-pocket costs for medications

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What is viatris patient assistance program?

The Viatris Patient Assistance Program provides assistance to eligible patients who are struggling to afford their medications.

Who is required to file viatris patient assistance program?

Patients who meet the eligibility criteria for the program are required to file for assistance.

How to fill out viatris patient assistance program?

To fill out the Viatris Patient Assistance Program, eligible patients can visit the official website or contact the program representatives for assistance with the application process.

What is the purpose of viatris patient assistance program?

The purpose of the Viatris Patient Assistance Program is to provide financial assistance to patients in need, helping them access the medication they require for their treatment.

What information must be reported on viatris patient assistance program?

Patients may be required to provide information related to their medical condition, financial situation, and insurance coverage to qualify for assistance.

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