FAIR CREDIT REPORTING ACT (FCRA) AUTHORIZATION (FOR NOVARTIS PATIENT ASSISTANCE FOUNDATION, INC. [NPAF] PROGRAMS ONLY)

I understand that I am providing “written instructions” under the FCRA, authorizing NPAF and its vendor, on an ongoing basis as needed for the duration of my participation in programs administered by NPAF, to obtain information from my credit profile or other information from the vendor, solely for the purpose of determining financial qualifications for programs administered by NPAF. I understand that I must affirmatively agree to these terms in order to proceed in this financial screening process.