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Please select “yes” or “no” for the following questions. Your answers will determine your eligibility for this program.

Do you purchase your prescription medication through a federal or state prescription drug program, such as Medicare or Medicaid?

You are not eligible for the program at this time.

Do you currently live in the United States or its territories?

You are not eligible for the program at this time.

Are you 18 years of age or older?

You are not eligible for the program at this time.

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

Please complete the form below to access your Pfizer Co-Pay One Savings Card.
Confirm which medication you have been prescribed.**
Privacy Statement: Pfizer understands that your personal and health information is private. The information you provide will only be used by Pfizer and parties acting on its behalf to send you the materials you requested as well as other helpful product and/or related product information, disease state information, offers and services. 
Please fill in the required fields.**
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