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Provigil Patient Assistance Program
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C/O NORD
PO Box 1968
Danbury, CT 06813-1968
Phone
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800-675-8415
Fax:
203.798.2964
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Eligibility
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The patient must have no insurance and meet income guidelines that are not disclosed. |
| Who Can Apply
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The patient or doctor needs to call for a prescreening. |
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Required
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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. |
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Supply
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A coupon for 90-day supply |
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Ship To
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Patient's home |
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Note
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The patient or doctor needs to call for a prescreening. |
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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.
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| Provigil (modafinil) |
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