Access 360 General Patient Authorization Form (PAF)

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Access 360 General Patient Authorization Form (PAF)

Access 360 Patient Authorization Form (PAF)

Fill this form out to allow Access 360 to provide assistance for your IMFINZI prescription. Available in English and Spanish. The IMFINZI Enrollment Form must be signed by the patient to utilize Access 360 patient-specific support.

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Click here to fill out the form online.

IMFINZI Affordability Brochure

IMFINZI Affordability Brochure

This brochure explains affordability options for IMFINZI if you are eligible.