2. Include the following documents

• Proof of Income.
• An original signed prescription for your GSK medicine.Faxed prescriptions are only valid if they are faxed directly from a physician’s office. Faxed prescriptions received from any other location will not be accepted and will delay medication shipment to the patient.(Note: Be sure to print the applicant's name and date of birth on each page of documentation submitted.)

3. Submit Your Paperwork to Bridges to Access

• Fax or mail your completed and signed application, income documentation, and prescription(s) for your GlaxoSmithKline medicines to:
  BRIDGES TO ACCESS^®
  P.O. Box 29038
  Phoenix , AZ 85038-9038
  Fax Number: 1-855-474-3063
  (faxed prescriptions are only valid if they are faxed directly from a physician’s office)

• Once your application is received and processed, you will receive a letter that lets you know whether or not you have been enrolled in Bridges to Access.

How to Re-enroll

For details on how to re-enroll in Bridges to Access, click here.

How to Receive Medication

To find out how to receive medication and refills, click here.