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OCPW10029134
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Please answer the following questions. Your answers will determine the patient's eligibility for this program.

Does the patient purchase his or her prescription medication through a federal or state prescription drug program, such as Medicare or Medicaid?

The patient is not eligible for the program at this time.

Does the patient currently live in the United States or its territories?

The patient is not eligible for the program at this time.

Is the patient 18 years of age or older?

The patient is not eligible for the program at this time.

Are you licensed to practice medicine in the state of Vermont?

This offer is not valid in your state.

Are you a pharmacist in the states of Louisiana or Colorado?

This offer is not valid in your state.

To learn about other financial assistance options, click here to visit Pfizer RxPathways.

Confirm which medication the patient has been prescribed.
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