RxAssist - NOVARTIS PHARMACEUTICALS CORPORATION - Novartis ... 2026

1. Click ‘Get Form’ to open the RxAssist application in the editor.
2. Begin with Patient Section 1. Fill in your personal information accurately, including your name, date of birth, and contact details. This is crucial for determining your eligibility.
3. In Patient Section 2, if you have insurance, upload copies of both sides of your insurance cards. This helps verify your coverage.
4. Proceed to Patient Section 3. Choose how you want to verify your income: either through an electronic check (if you're over 18) or by uploading financial documents like tax returns or pay stubs.
5. In Patient Section 4, decide if you want to receive automated reminders for refills by checking the appropriate consent box.
6. Finally, complete Patient Section 5 by reading and signing the authorization page at the bottom of the application.

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