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 Connect Patient Assistance Program Enrollment Form

Connect Patient Assistance Program Enrollment Form

Use a Connect Patient Assistance Program Enrollment Form template to make your document workflow more streamlined.

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Video instructions and help with filling out and completing Connect Patient Assistance Program Enrollment Form

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Instructions and help about Connect Patient Assistance Program Enrollment Form

at merck we believe no one should go without the medicines they need that is why the company provides certain medicines and adult vaccines free of charge to people who do not have prescription drug or health insurance coverage and who without our assistance cannot afford their merck medicines and vaccines this short video will explain how to fill out the enrollment form for the merck patient assistance program to get this form click on the merck patient assistance program tab in the frequently asked questions section of merckhelps.com click on your medication's name from the products listed on merckelps.com or call 800-727 medicines or adult vaccines distributed through the merck patient assistance programs are free of charge to all eligible patients you may qualify for the merck patient assistance program if you reside in the united states or u.s territory you do not need to be a u.s citizen you have a prescription for merck medicine from a healthcare provider licensed in the united

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