LUCENTIS Access Solutions

Committed to helping patients access the Genentech medicine they need 

Forms & Documents

Download enrollment forms, sample letters, tips and checklists 

Patient
Assistance Tool

Find the right assistance option for your patients 

Coverage

Help understanding benefits and coverage, such as benefits investigations and prior authorization resources

 

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Reimbursement

Sample coding information and resources for denials and appeals

 

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Product Distribution

A list of authorized distributors and specialty pharmacies as well as information on our Spoilage Replacement Program 

 

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Learn About Treatment With LUCENTIS >

Download the forms you need to get started

View LUCENTIS Forms and Documents >

Latest Updates

Form: SMN

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Form: PAN

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PAN=Patient Authorization and Notice of Request for Transmission of Health Information to Genentech Access Solutions and Genentech® Access to Care Foundation.

SMN=Statement of Medical Necessity.