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ONFI Patient Assistance Program
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Phone
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855-345-6634
Fax:
855-547-8278
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Eligibility
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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
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Doctors |
Required
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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. |
Supply
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Not specified |
Ship To
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Not specified |
Note
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Resources for HEALTHCARE PROFESSIONAL ONLY.
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. |
Onfi tablet |
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Printable Application Forms Applications that patients can fill out and bring to their doctor. |
Download printable Form |
(Requires Acrobat Reader)
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