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Patient Assistance Information

1 Program for Onfi tablet
ONFI Patient Assistance Program

Phone : 855-345-6634
Fax: 855-547-8278
> ONFI Patient Assistance Program eligibility is determined on a case by case basis. Income requirements have not been disclosed for this program. Medication must be medically necessary as determined by a doctor. US residency requirements have not been specified.
Who Can Apply
> Doctors
> Doctors must send a referral form to the program to begin the application process. The form can be faxed, mailed or downloaded. Doctors must complete and sign and fax or mail from their office.
> Not specified
Ship To
> Not specified
> Resources for HEALTHCARE PROFESSIONAL ONLY. This program also provides copay assistance.
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.
Onfi tablet
Printable Application Forms
Applications that patients can fill out and bring to their doctor.
Download printable Form
(Requires Acrobat Reader