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Nexavar Reach Program
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PO Box 220765
, NC 28222-0765
Phone
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877-322-4448
Fax:
866-639-5181
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Eligibility
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The patient must have no prescription coverage for the requested medication and meet income and other eligibility guidelines that are not disclosed. |
| Who Can Apply
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Anyone requesting assistance can call to request a faxed application or download it from the website. |
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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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Ship To
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Patient's home |
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Note
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Anyone requesting assistance can call to request a faxed application or download it from the website. |
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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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| Nexavar |
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Printable Application Forms
Applications that patients can fill out and bring to their doctor.
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| Download printable Form Application Form |
| Download printable Form Spanish Version |
(Requires Acrobat Reader) 
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