What is the Patient Assistance Program?
In order to ensure that all of our customers have access to the medication that their doctors think is most beneficial we have created the Patient Assistance Program to offer financial assistance to customers that may otherwise be unable to afford Donnatal®.
If you have patients that have been prescribed Donnatal® and they are in need of financial assistance to maintain their regimen, please contact us.
Applying is simple.
1Download the enrollment packet, complete the forms, and return them to our Customer Service Department.
A list of forms to be completed and documentation supplied by you:
- The enrollment application form (in the packet)
- The HIPAA form (in the packet)
- Most recent Federal Income Tax Return IRS Form 1040
- Recent paycheck stubs showing your income for the past 30 days
2The Customer Service Manager will collect your information and contact your physician to verify the details.
3Once your details have been verified we will ship your medication directly to your doctor’s office. It’s that easy.