Applications

Connection to Care Connection to Care®

For new patient applications (general application)

Download English application
Download Spanish application
Application Instructions Video

MAINTAIN MAINTAIN

Applications for enrollment in MAINTAIN will be accepted through December 31, 2012.

Download English application
Download Spanish application

MAINTAIN Pfizer Pfriends*

Download English application
Download Spanish application

RSVP

Download English application
Download Spanish application

First Resource First Resource®

Download Oral medicines English application
Download IV medicines English application
Download Oral medicines Spanish application
Download IV medicines Spanish application

*The Pfizer Pfriends savings program is not health insurance. For a complete list of participating pharmacies, please click here or call the toll-free number 866-706-2400. There are no membership fees to participate in the Pfizer Pfriends program. Estimated savings range up to 15-36% and depend on such factors as the particular drug purchased, amount purchased, and the pharmacy where purchased.