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Your Information

Prescriber Information

Location Information

Novartis Patient Support
Access Portal Registration Form

Purpose: To Register a new Access Portal account for your practice, you must include:

  • at least 1 portal user and 1 designated portal administrator
  • at least 1 prescriber
  • all locations to be included in your portal account

* Required fields are denoted with asterisks

Needed Information:

Please have this information available to complete the registration fields:

  • Portal Users: Name(s), email address
  • Prescriber(s): NPI, email address
  • Practice Locations: Practice Location NPI
Your Practice Information
Your Information

At least one user must be a Portal Administrator

If you experience any issues or need assistance completing the form, please contact Novartis Customer Support at 1‑844‑367‑3222 or email customerserv-us.aaa@novartis.com.