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What questions will applicants for prescription assistance have to answer?

You should be prepared to provide the following information about the patient:

Age
State of residence and ZIP code
Estimated gross annual household income
Number of people living in household
Brand name of prescription medicines they are currently taking or have been prescribed
Type of health insurance and/or prescription coverage (if applicable)

Your responses to these questions are completely confidential.
 

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.