/
Lilly Cares Patient Assistance Program Refill Authoriz Lilly Cares Patient Assistance Program Refill Authoriz

Lilly Cares Patient Assistance Program Refill Authoriz - PDF document

jane-oiler
jane-oiler . @jane-oiler
Follow
561 views
Uploaded On 2015-05-12

Lilly Cares Patient Assistance Program Refill Authoriz - PPT Presentation

Send 4 month supply of the following product Product Sig Dosage Quantity If Insulin Please I nclude Maximum Daily Dose Shipping information including address NO PO BOX or THIRD PARTY VENDOR Health Care Provider ame OfficeClinic N ame ID: 65425

Send month supply

Share:

Link:

Embed:

Download Presentation from below link

Download Pdf The PPT/PDF document "Lilly Cares Patient Assistance Program R..." is the property of its rightful owner. Permission is granted to download and print the materials on this web site for personal, non-commercial use only, and to display it on your personal computer provided you do not modify the materials and that you retain all copyright notices contained in the materials. By downloading content from our website, you accept the terms of this agreement.


Presentation Transcript