ViiVConnect Quick Start

Patient Enrollment Form

Download the enrollment form:

English Español

Fax it to:

1-844-208-7676 (toll free)

Mail it to:

ViiVConnect Enrollment
PO Box 220100
Charlotte, NC 28222-0100

Upon receipt of enrollment form, a dedicated Access Coordinator will contact you.

ViiVConnect Portal

For Healthcare Professionals, Pharmacists, and Patient Representatives:

  • Secure online application
  • Online patient enrollment
  • Verify and track coverage
  • Submit prior authorizations
    Learn More
Register Today

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Rx Resources for Pharmacists

ViiVConnect Portal

For Healthcare Professionals, Pharmacists, and Patient Representatives:

Enroll patients 24/7 to verify and track coverage with our secure online resource tool.

Register (New Users) Sign In (Existing Users)

Learn more about the portal

Pill Bottle For Pharmacists

Visit the page for Pharmacists
to learn more about how
ViiVConnect can help at the pharmacy.

Learn More

Videos:

Welcome to ViiVConnect

About the Portal*

How to Enroll Patients*

*For Healthcare Professionals, Pharmacists, and Patient Representatives