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Endo Patient Assistance Program
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PO Box 66761
St. Louis, MO 63166-6761
Phone
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866-824-4747
Fax:
800-889-0353
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Eligibility
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The patient must have no prescription coverage for the requested medication and have an income at or below 200% of the FPL. Medicare partD Patient's are eligible if medication is not covered. The patient must also be a US resident. |
| Who Can Apply
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Call for application to be faxed. Application must be faxed or mailed back to company from Doctor's office. Patient and Doctor will be notified by mail of decision in 5-7 business days. |
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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 application and attach proof of income. |
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Supply
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Up to a 90-day supply. Doctor/Doctor's office must contact company for refills. Refill limit not specified. New application must be completed every 3 months. |
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Ship To
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Medication is shipped to Doctor's office within 2 weeks. |
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Note
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No online application available. |
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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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| Frova Tablet |
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