Registered Users Log-in:

E-mail Address:
 

Password:
 

  
Forgot Password?
Registration
 
Patient Assistance Information

 
 
 
PegAssist Program

14042 B Riverport Dr
Maryland Heights, MO 63043
Phone : (866) 247-5084
Fax:
Eligibility
> Eligibility is based on patient's income and lack of third party precription coverage.
Who Can Apply
> Anyone may call to initiate application process.
Required
> Patient's proof of income is required as well as an original prescription.
Supply
> 30 days.
Ship To
> Physician's office or Patients Home
Note
> A prescreening is done on initial phone call. If qualified, an application is sent to the physician's office for completion. The application, patient's proof of income and an original, legal prescription must be mailed in order for the patient to continue to receive medication.