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Patient Assistance Information

 
1 Program for Provigil (modafinil)
 
 
Provigil Patient Assistance Program

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