Patient Portal Access

Prescription
Assistance
This page provides information and forms from pharmaceutical companies.  This information is for patients to use to request assistance from the pharmaceutical companies to help pay for their prescription medications.

 http://www.merck.com/merckhelps/patientassistance/home.html



http://www.colcrys.com/patient-assistance-program.htm


http://www.DiabetesAccessSupport.com


 
Bristol-Myers Squibb Patient Assistance Information and ApplicationInformation and application for the Bristol-Myers Squibb Patient Assistance Program.
sanofi-aventis APPEAL FOR MEDICARE PART DIf you have Medicare Part D you will need to complete this form along with the application. Both forms can be submitted together.
sanofi-aventis Patient Assistance Information and ApplicationInformation and application for the sanofi aventis Patient Assistance Program.
Merck Patient Assistance ApplicationFor more information, a link to the Merck Patient Assistance page is available from this page.
Sanofi Patient Assistance ApplicationPatient to complete page 2 of application to apply for assistance from Sanofi.
PACE Prescription Assistance InformationContact information for PACE.

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