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Your Pfizer Patient Affairs Liaison is a professional dedicated to serving you by connecting patients and caregivers with Pfizer tools and resources.

We are committed to continuing Pfizer’s more than 20 years of listening to the community and working to meet its needs.

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Pfizer Patient Affairs Liaison Authorization and Communication Opt-In Form

Your Pfizer Patient Affairs Liaison is a professional dedicated to connecting patients and caregivers with Pfizer educational information and programs. Patient Affairs Liaisons work with community-based patient organizations to understand their needs and provide educational programs for patients and their families about living with rare diseases. Pfizer Patient Affairs Liaisons do not provide medical advice and will recommend that you raise any treatment-related questions directly with your healthcare provider.

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To get started, Please select the appropriate disease state below:
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PAL LogoPAL Authorization

By completing the form below, I request and agree to authorize a Pfizer Patient Affairs Liaison to contact me regarding Pfizer’s educational information for the selected disease state (such as materials about the disease, or information about community events happening in my area).

Consent is not a condition of purchase or use of any Pfizer product or service.

I understand that I can opt-out of these communications at any time by contacting the Pfizer Patient Affairs Liaison.

I am a...*
How would you like to be contacted?*
Used for phone call only
Used for mail only

PAL

Pfizer Patient Affairs Liaison Authorization and Communication Opt-In Form

Your Pfizer Patient Affairs Liaison is a professional dedicated to connecting patients and caregivers with Pfizer educational information and programs. Patient Affairs Liaisons work with community-based patient organizations to understand their needs and provide educational programs for patients and their families about living with rare diseases. Pfizer Patient Affairs Liaisons do not provide medical advice and will recommend that you raise any treatment-related questions directly with your healthcare provider.

* fields are required

To get started, Please select the appropriate disease state below:

PAL LogoPAL Authorization

By completing the form below, I request and agree to authorize a Pfizer Patient Affairs Liaison to contact me regarding Pfizer’s educational information for the selected disease state (such as materials about the disease, or information about community events happening in my area).

Consent is not a condition of purchase or use of any Pfizer product or service.

I understand that I can opt-out of these communications at any time by contacting the Pfizer Patient Affairs Liaison.

I am a...*
How would you like to be contacted?*
Used for phone call only
Used for mail only

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