Tell us a little about your needs. Your coordinator can explain the information needed for a medical review.
Complete the form to begin. Please keep this first message brief and avoid including sensitive medical details.
If you need to share a medical document, use the separate private document submission page.
Complete the assessment form with your contact details and treatment interest. A coordinator will explain what information is needed next.
Clinical decisions are made by the treating medical team after reviewing your individual circumstances. Long Life coordinates access and the patient journey.
