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Getting Started When You Want to Enroll on Your Own by Mail
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To Enroll
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For help completing the application, call Bridges to Access at 1-866-PATIENT (1-866-728-4368).
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Send the completed and signed application, income documentation
and prescription(s) for your GlaxoSmithKline medicine(s) to:
Bridges to Access
P.O. Box 29038
Phoenix, AZ 85038-9038
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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.
To Receive Medicine
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If you are enrolled, the first 90-day supply of your GlaxoSmithKline medicine(s) will
automatically be shipped to the address provided on the application.
(Some drugs are only available at a retail pharmacy. You will be notified if your prescription is only available at a retail pharmacy.)
To Order Refills
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Order your refills 3 weeks before you run out of medicine.
To order refills click here
or call 1-866-PATIENT (1-866-728-4368).
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Refills are sent at no cost to you for up to 12 months after your enrollment in Bridges to Access.
To Re-Apply
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You will need to re-apply in Bridges to Access every 12 months to continue receiving assistance.
Bridges to Access will mail a re-enrollment application when it is time to re-apply.
You can re-apply on your own by mailing in the completed application or you can ask someone
involved in your healthcare to help you complete the form and mail it in.
If you are determined eligible for continued assistance through Bridges to Access, your first refill will
automatically be sent to the address provided on the application.
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