The purpose of this website is to allow patients and their caregivers to electronically sign the Access 360 Patient Authorization Form (PAF), providing consent to allow Access 360 as well as employees, contractors, or affiliates of AstraZeneca that perform access support to have Protected Health Information (PHI).
This authorization is required in order for Access 360 to provide access and reimbursement resources for patient-specific support.
Questions regarding the Access 360 program or the Access 360 Patient Authorization Form?
This website is intended for people who would like to participate in Access 360 program.
This site is intended for US audiences only.
ARIMIDEX, CALQUENCE, CASODEX, FASLODEX, IMFINZI, IRESSA, LYNPARZA, SYNAGIS and TAGRISSO are registered trademarks, and FASENRA and AstraZeneca Access 360 are trademarks of the AstraZeneca group of companies. All other trademarks are property of their respective owners.