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Bradley Pharmaceuticals Patient Assistance Program
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383 Route 3 West
Fairfield, NJ 07004
Phone
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(800) 929-9300
Ext 584
Fax:
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Eligibility
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Eligibility is based on income and lack of third party prescription coverage. |
| Who Can Apply
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Application information is taken over the phone. |
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Required
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Caller must provide complete physician information (including DEA, State License, phone and fax numbers) as well as complete patient information. |
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Supply
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90 days. |
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Ship To
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Physician's office. |
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Note
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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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| Rosula (sodium sulfacetamide & sulfur) |
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Printable Application Forms
Applications that patients can fill out and bring to their doctor.
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| Download printable Form Application Form |
(Requires Acrobat Reader) 
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Doak Dermatologics Rebate Program
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PO Box 540007
El Paso, TX 88554-0007
Phone
:
800-405-3625
Fax:
610-232-2020
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Eligibility
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This company doesn't have an assistance program but does have a rebate program. |
| Who Can Apply
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Required
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Supply
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Ship To
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| > |
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Note
|
| > |
|
| |
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.
|
| Rosula (sodium sulfacetamide & sulfur) |
| |
Printable Application Forms
Applications that patients can fill out and bring to their doctor.
|
| Download printable Form Application Form |
| (Requires Acrobat Reader)
|
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