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Patient Assistance Information

 
1 Program for Intuniv Extended Release Tablets
 
 
Shire Cares

Shire Cares Patient Assistance & Support Program
PO Box 5666
Louisville, KY 40255
Phone : 888-227-3755
Fax: 877-922-7379
Eligibility
> Patients insurance status will be considered on a case by case basis. Medicare Part D recipients are eligible. Patients must be at or below 300% of the Federal Poverty Level, must have an FDA-approved diagnosis and must be a US citizen or legal entrant.
Who Can Apply
> Patients or healthcare providers can call to have an application faxed, mailed or it can be downloaded.
Required
> Doctors must complete a section of the application and sign. Patients must complete a section, sign, attach proof of income and attach any insurance information.
Supply
> Not specified
Ship To
> Patient is sent a card to be used at the pharmacy.
Note
> Each Application will be considered on a case by case basis.
 
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.
 
Intuniv Extended Release Tablets
 
Printable Application Forms
Applications that patients can fill out and bring to their doctor.
 
Download printable Form
Download printable Form
(Requires Acrobat Reader