Registered Users Log-in:

E-mail Address:
 

Password:
 

  
Forgot Password?
Registration
 
Patient Assistance Information

 
Program Sponsored By CoTherix, Inc. (External Link)
 
 
Ventavis Patient Assistance Program


,
Phone : 877-483-6828 Ext OPT 2
Fax:
Eligibility
> The patient must have no insurance and meet income guidelines that are not disclosed. The patient must also be a US resident.
Who Can Apply
> The doctor, patient, social worker or patient advocate must call for a prescreening.
Required
> The doctor must fill out and sign the enrollment form.The patient must fill out a section of the enrollment form and sign it.
Supply
> Up to a 30-day supply
Ship To
> Either Doctor's office or Patient's home
Note
> The doctor, patient, social worker or patient advocate must call for a prescreening.
 
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.
 
Ventavis Inhaltaion Solution