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Patient Assistance Information

 
 
 
Berlex Oncology CamCare Program

Berlex Oncology CamCare Program
PO Box 221289
Charlotte, NC 28222-1289
Phone : (800) 473-5832
Fax: (800) 513-1824
Eligibility
> Patient must be physicially residing in the US or its territories and must be ineligible for third party prescription coverage.
Who Can Apply
> Anyone may call to initiate application process.
Required
> Completed application with original signatures is required.
Supply
> As requested by physician.
Ship To
> Physician's office.
Note
>
 
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.
 
Campath
Fludara (fludarabine phosphate)
Leukine (sargramostim)
 
Printable Application Forms
Applications that patients can fill out and bring to their doctor.
 
Download printable Form Application Form
(Requires Acrobat Reader