This brief form, once completed, gives Access 360 the ability to provide select services to a patient seeking assistance. Available in English and Spanish. The Access 360 General Patient Authorization Form must be signed by the patient to utilize Access 360 patient-specific support.
This resource provides specific codes related to diagnosing and billing for FLUMIST QUADRIVALENT.
This template can be used by a healthcare provider to appeal a denial of access to an AstraZeneca medicine.
