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Patient Assistance Information

1 Program for Tegretol
Novartis Patient Assistance Foundation, Inc.

PO Box 52029
Phoenix, AZ 85072
Phone : 800-277-2254
Fax: 855-817-2711
> This program provides brand name medications at no or low cost to patients that have no prescription coverage. Patients with Medicare Part D are not eligible. Income requirements for this program have not been disclosed. Patients must be a US resident.
Who Can Apply
> Patients or healthcare providers can call to have an application faxed or download one.
> Doctors must complete a portion of the application, sign and attach a prescription for 90 days. Patients must complete a portion of the application, sign and attach a copy of proof of income.
> Varies
Ship To
> Doctor's office or patient is sent card to be used at pharmacy.
> For Focalin XR, Clozaril, and Ritalin LA, Clozarila pharmacy card will be issued. All other medication will be shipped directly to the physician.
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.
Printable Application Forms
Applications that patients can fill out and bring to their doctor.
Download printable Form
Download printable Form
(Requires Acrobat Reader