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Sucraid Patient Assistance Program
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c/o Accredo Health Group, Inc.
1640 Century Center Pkwy
Memphis, TN 38134
Phone
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(800)705-1962
Fax:
800-632-1944
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Eligibility
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The patient must have no insurance and meet income guidelines that are not disclosed. The patient must also have an FDA approved diagnosis. |
| Who Can Apply
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With the patient's permission, anyone concerned can call for an application. |
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Required
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The doctor must fill out a section, sign the application and attach a prescription.The patient must fill out a section, sign the application and attach insurance information. |
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Supply
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Up to a 30-day supply |
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Ship To
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Patient's home, unless otherwise noted |
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Note
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This program also provides copay assistance. |
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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.
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| Sucraid oral solution |
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Printable Application Forms
Applications that patients can fill out and bring to their doctor.
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| Download printable Form |
(Requires Acrobat Reader) 
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