When in doubt, contact the program directly for details. Most pharmaceutical companies state that the purpose of their patient assistance program is to fill a temporary need for patients who do not qualify for any public assistance, and do not have private insurance coverage, or the financial resources needed to obtain the prescription medication. Pay careful attention to any criteria guidelines. We are able to replicate on-line versions of forms for only those programs which allow copies to be made. At this time that represents about 30 percent of the programs.
Many companies send personalized forms with tracking numbers specific to the patient.
Others ask for letters from the provider confirming certain eligibility standards. Despite our best attempts, forms are altered frequently. Please be sure to let us know if you learn of such a change. The on-line forms require Adobe Acrobat Reader 3.01 or later. For more information about using the on-line forms, or downloading this widely available shareware software, click here .