Registered Users Log-in:

E-mail Address:


Forgot Password?
Patient Assistance Information

Program Sponsored By Onset Dermatologics (External Link)
Onset Patient Assistance Program

PO Box 42886
Cincinnati, OH 45242
Phone : (800) 956-0697
Fax: (513)618-0059
> Patient must be a legal resident and ineligible for prescription drug assistance through Medicaid or private insurance. Patient must meet established financial criteria.
Who Can Apply
> Healthcare providers or patients can initiate the application process.
> The application must be completed and signed by both the patient and the healthcare provider. The patient must also sumbit documentation of the gross annual household income.
> A 30 day supply is shipped for all products.
Ship To
> Medication will be shipped to the Healthcare Provider's office.
> Complete financial re-application is required annually. Renewal requests within the same year require only the application form signed by the healthcare provider.
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.
Aurstat® Anti-Itch Hydrogel
Aurstat® Anti-Itch Kit
Clindagel® Gel
Hylatopic Plus® Cream
Hylatopic Plus® Foam
Locoid® Lotion
Minocin® Capsules
Tretin-X Cream
Printable Application Forms
Applications that patients can fill out and bring to their doctor.
Download printable Form Application Form
(Requires Acrobat Reader