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Patient Assistance Information

 
3 Programs Sponsored By Duramed Pharmaceuticals (External Link)
 
 
Enjuvia Patient Assistance Program

250 Phillips Blvd
Ste 250
Ewing, NJ 08618
Phone : 800-425-3122
Fax: 800-685-2577
Eligibility
> The patient can have no public or private prescription insurance and have an income at or below 200% of the Federal Poverty Level. The patient must also be a US resident. The patient must also be over the age of 18.
Who Can Apply
> The doctor or patient can call to request an application.
Required
> The doctor must fill out a section and sign the application.The patient must fill out a section, sign the application and attach any insurance information.
Supply
> Up to a 90-day supply
Ship To
> Doctor's office
Note
> A new application is needed for each refill.
 
Includes Support for This Drug
NOTE: Linked drugs are available for Prescribers to Apply Online now.
Click drug logo or drug name to start online application.
 
Enjuvia Tablets
 
Printable Application Forms
Applications that patients can fill out and bring to their doctor.
 
Download printable Form Application Form
(Requires Acrobat Reader
 
 
Seasonique Patient Assistance Program

250 Phillips Blvd
Ste 250
Ewing, NJ 08618
Phone : 800-425-3122
Fax: 800-685-2577
Eligibility
> The patient can have no public or private prescription insurance and have an income at or below 200% of the Federal Poverty Level. The patient must also be a US resident. Patient must be 18 years old or older.
Who Can Apply
> The patient or doctor should call for an application.
Required
> The doctor must fill out a section and sign the application.The patient must fill out a section, sign the application and attach proof of income.
Supply
> An Extended-Cycle Tablet Dispenser consisting of a 91-day supply.
Ship To
> Doctor's office
Note
> The patient or doctor should call for an application.
 
Includes Support for This Drug
NOTE: Linked drugs are available for Prescribers to Apply Online now.
Click drug logo or drug name to start online application.
 
Seasonique Tablets
 
Printable Application Forms
Applications that patients can fill out and bring to their doctor.
 
Download printable Form Application Form
(Requires Acrobat Reader
 
 
Cenestin Patient Assistance Program

250 Phillips Blvd
Ste 250
Ewing, NJ 08618
Phone : 800-425-3122
Fax: 800-685-2577
Eligibility
> The patient must have no prescription coverage for the requested medication and have an income at or below 200% of the Federal Poverty Level. The patient must also be a US resident. Patient must be 18 years of age or older.If a patient is eligible for Medicare Part D but does not enroll then s/he may still be eligible for this program. But if a patient enrolls in Part D, and it doesn't cover Cenestin then s/he is not eligible for this program.
Who Can Apply
> Anyone requesting assistance can call to request a faxed application or download it from the website.
Required
> The doctor must fill out a section and sign the application.The patient must fill out a section, sign the application and attach proof of income.
Supply
> Up to a 90-day supply
Ship To
> Doctor's office
Note
> The patient or doctor must contact the company for refills. Every year a new application is needed.
 
Includes Support for This Drug
NOTE: Linked drugs are available for Prescribers to Apply Online now.
Click drug logo or drug name to start online application.
 
Cenestin (synthetic conjugated estrogens, A)
 
Printable Application Forms
Applications that patients can fill out and bring to their doctor.
 
Download printable Form Application Form
(Requires Acrobat Reader