Shire cares 2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin by completing Section 1, which requires your treating and referring physician's information. Ensure all fields are filled accurately.
3. In Section 2, provide the patient's name, diagnosis, and prescription details. Select the appropriate product and dosage as prescribed.
4. Move to Section 3 to fill out the patient’s personal information including name, date of birth, and contact details.
5. In Section 4, enter financial information about your household income. Attach proof of income as required.
6. Complete Section 5 regarding insurance information. If applicable, attach a copy of your insurance card.
7. Finally, review all sections for completeness and accuracy before signing in Section 6. Submit the form via fax or mail as instructed.

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