Transcription of Application for Free AstraZeneca Medicines
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Application for Free AstraZeneca Medicines
Application for free AstraZeneca Medicines : Specialty Care Products PO Box 898, Somerville, NJ 08876. How to Complete this Application : 1. Review the information on this page carefully and keep it for your records. 2. Complete pages 3, 4 and 5 of the Application . 3. Gather the required documentation listed on page 2. 4. Mail or fax your completed Application and required documentation following the instructions on the next page. What are the AZ&Me Prescription Savings Programs? The AZ&Me Prescription Savings Programs (the Program) are a group of programs offered by AstraZeneca that allow you to get free Medicines if you qualify.
Application for Free AstraZeneca Medicines Specialty Care Products Page 2 of 5 AZ&Me Prescription Savings Program Application Checklist The following items must be submitted by mail or by fax to complete your application, even if
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