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AbbVie Patient Assistance Foundation fax number

(866) 250-2803

Patient Assistance Program

Used for: Submitting HUMIRA patient assistance applications (for HUMIRA adalimumab).

Fax destination details

Department
Patient Assistance Program
Purpose
Submitting HUMIRA patient assistance applications (for HUMIRA adalimumab).
Form
H-APP1-16C-1 — Patient Assistance Application for HUMIRA® (adalimumab)
Address
AbbVie Patient Assistance Foundation, D-617927, AP5 NE, 1 N. WAUKEGAN RD, North Chicago, IL 60064
Voice phone
1-800-222-6885

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Complete Patient Information, Prescriber Information, and Shipping/Insurance sections; sign the Patient Certification and Authorization for Disclosure; fax to 1-866-250-2803 or mail to AbbVie Patient Assistance Foundation, D-617927, AP5 NE, 1 N. Waukegan Rd., North Chicago, IL 60064.

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