Thank you for your submission.

A member of the Papzimeos SUPPORT team will review and reach out to the office contact listed under the Prescriber Information section of the form with any questions. Your patient will receive an email via DocuSign to review and sign the Patient Authorization section of the form. We recommend reaching out to your patient to let them know about this step so that they can respond promptly and continue the enrollment process.

Please reach out to Papzimeos SUPPORT at (866) 827-8180, Monday to Friday, 8 AM to 8 PM ET with any questions.

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