|
Innohep Patient Assistance Program
|
PO Box 18979
Louisville, KY 40261
Phone
:
866-742-7646
Ext OPT 4, OPT 2
Fax:
866-369-4333
|
Eligibility
|
> |
The patient must not have any private nor public insurance and be financially unable to afford the medication. The patient must also be a US resident. |
Who Can Apply
|
> |
With the patient's permission, anyone concerned can call for an application. |
Required
|
> |
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. |
Supply
|
> |
Up to a 30-day supply |
Ship To
|
> |
|
Note
|
> |
With the patient's permission, anyone concerned can call for an application. |
|
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. |
Innohep (tinzaparin sodium) |
|
Printable Application Forms Applications that patients can fill out and bring to their doctor. |
Download printable Form Application Form |
(Requires Acrobat Reader)
|
|
|