Forms and Documents

To download multiple files at once, select the checkbox next to each file you would like to download from the list below then click Download Selected. Documents will be downloaded as a .zip file.

OCREVUS Access Solutions Enrollment Forms

The SMN and PAN are required for enrollment in OCREVUS Access Solutions.

Prior Authorization Checklists and Tips

Appeals Checklists and Tips

Other Important Documents

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.