|
Tobi Patient Support Program
|
TOBI Patient Support Program
250 Technology Park Lake Mary, FL 32746
Phone
:
(866) 598-8624
Fax:
|
Eligibility
|
> |
Patients 6 years of age and older who have Cystic Fibrosis, meet the program's income guidelines and have no access to health insurance benefits. Patients must be permanent US residents. |
Who Can Apply
|
> |
Physician's office must call on patient's behalf. |
Required
|
> |
Income and insurance information required along with a signed application and a legal prescription. |
Supply
|
> |
1 box (28-day supply) |
Ship To
|
> |
Cystic Fibrosis Pharmacy mails one box of medication to patient's home. |
Note
|
> |
Completely new application must be filed every 6 months. |
|
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. |
Tobi (tobramycin) |
|
Printable Application Forms Applications that patients can fill out and bring to their doctor. |
Download printable Form Application Form |
(Requires Acrobat Reader)
|
|
|