|
Baxter Factor Plus Program
|
5870 Trinity Parkway
Suite 600 Centreville,, VI 20120
Phone
:
888-229-8379
Fax:
800-643-9450
|
Eligibility
|
> |
The patient must have no insurance and be financially unable to afford the medication. The patient must also be a US resident. |
Who Can Apply
|
> |
The doctor/doctor's office should call for an application. |
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
|
> |
|
Ship To
|
> |
Hospital, Doctor's office or Pharmacy |
Note
|
> |
The doctor/doctor's office should call for an application. |
|
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. |
Advate Powder for Injection |
|
Printable Application Forms Applications that patients can fill out and bring to their doctor. |
Download printable Form Application Form |
(Requires Acrobat Reader)
|
|
|