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Patient Assistance Information

 
 
 
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