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Patient Assistance Information

 
1 Program for Avelox IV
 
 
Schering Laboratories Patient Assistance Program

PO Box 6842
Somerset, NJ 08875
Phone : 800-656-9485 Ext OPT2
Fax: Not Applicable
Eligibility
> The patient must have no prescription coverage for any medications and have an income at or below 200% of the Federal Poverty Level. This is a hospital replacement program, so the patient must have already received the medication.The patient must also be a US resident.
Who Can Apply
> Someone from the hospital must call for an application.
Required
> The hospital contact person must fill out and sign the application.The patient must provide information (financial, insurance, and medical) but no signature is required.
Supply
>
Ship To
> Hospital
Note
> Someone from the hospital must 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.
 
Avelox IV
 
Printable Application Forms
Applications that patients can fill out and bring to their doctor.
 
Download printable Form Application Form
(Requires Acrobat Reader