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Patients may complete this form electronically. Web rheumatology enrollment form | humira ambassador program. Web find prescription and enrollment forms, patient support, and other resources for humira, a tnf blocker for various. Web symptoms include shortness of breath, swelling of your ankles or feet, and sudden weight gain. Web application for humira® (adalimumab) north chicago, il 60064 phone: Web register for humira complete to access helpful resources like injection training, cost savings, support, and more. My signature on this enrollment form indicates i am requesting a registered nurse to either (i) provide.