Enrollment

Enrolling your patient in AAA PatientCONNECT and accessing financial assistance is a simple 3 step process:

  • Step 1: Access the Enrollment Forms

    Enrollment forms for AAA PatientCONNECT may be accessed on this website by clicking here, by calling 1-844-638-7222, or by speaking with your AAA Regional Access Manager.

  • Step 2: Complete and Sign the Enrollment Forms

    Complete all required sections of the enrollment forms and make sure that both you and your patient sign the form. Fax this form to 1-844-638-7329.

  • Step 3: Speak with a Patient Navigator

    A Patient Navigator will follow-up with the physician to confirm enrollment and inform the patient of the next steps. They may also contact your patient if there are any questions or further information is required.

If preferred, an online portal is also available for enrollment. Click here to access the online portal.

Please be informed that we have adopted new enrollment forms, starting from February 22nd 2021. If you need assistance with completing the forms, please call AAA PatientCONNECT at 1-844-638-7222.
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