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The document outlines the application process for the Amgen Safety Net Foundation, a nonprofit organization that provides qualifying patients with access to Amgen medications at no cost. It details eligibility requirements, including specific medications, residency in the U.S. or territories, lack of insurance coverage, and income limits based on household size. The application process involves completing various sections regarding patient information, income, insurance status, and obtaining a prescription from a healthcare provider. Additionally, it includes patient certification and authorization for information disclosure.

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