# entry[].resource.item[].text
Patient Foundation Service Request Applied?

# entry[].resource.item[].answerOption[].valueString
Yes, please provide assistance locating an infusion site for patient

# entry[].resource.item[].answerOption[].valueString
No, please do not provide assistance locating infusion site

# entry[].resource.item[].text
Date of last treatment with an OCREVUS product (Optional)

# entry[].resource.item[].text
Is the site of treatment in the same hospital system as the prescriber?

# entry[].resource.item[].text
Does the patient have any health insurance?

# entry[].resource.item[].text
If insured, has the patient's insurance denied coverage for this medication?

# entry[].resource.item[].enableWhen[].answerString
Yes, please provide assistance locating an infusion site for patient

# entry[].resource.item[].text
Patient Foundation Service Request Applied?

# entry[].resource.item[].answerOption[].valueString
Yes, please provide assistance locating an infusion site for patient

# entry[].resource.item[].answerOption[].valueString
No, please do not provide assistance locating infusion site

# entry[].resource.item[].text
Is the site of treatment in the same hospital system as the prescriber?

# entry[].resource.item[].text
Does the patient have any health insurance?

# entry[].resource.item[].text
If insured, has the patient's insurance denied coverage for this medication?