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Suboxone Patient Assistance Program
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Here to Help Patient Assistance Program
PO Box 220281
Charlotte, NC 28222
Phone
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(888)898-4818
Fax:
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Eligibility
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The patient can have no public or private insurance and have an income at or below 250% of the federal poverty level. The patient must have medical diagnosis of opoid dependence. The patient must also be a US resident. |
| Who Can Apply
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The doctor, doctor's office or patient should call for an enrollment form. |
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Required
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The doctor must fill out a section and sign the application.The patient must fill out a section, sign the authorization and attach proof of income. |
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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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Pharmacy card sent to patient to obtain medication at a retail pharmacy. |
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Note
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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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| Suboxone film; sublingual |
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