BOTOX PATIENT ASSISTANCE Program
Allergan
Contact Information
BOTOX PATIENT ASSISTANCE™ Program
PO BOX 13185
La Jolla, CA 92039
1-(800) 442-6869 (phone)
BOTOX PATIENT ASSISTANCE™ Program
PO BOX 13185
La Jolla, CA 92039
1-(800) 442-6869 (phone)
Physician requests should be directed to:
BOTOX PATIENT ASSISTANCE™ Program
1-800-44-BOTOX, Option 6 (phone)
BOTOX PATIENT ASSISTANCE™ Program
1-800-44-BOTOX, Option 6 (phone)
How to Apply:
Select one of the links below to download the application or go to the program site for more information on how to apply. Once you fill out your application, send it to the address on the application. Do NOT send it to RxResource.
Select one of the links below to download the application or go to the program site for more information on how to apply. Once you fill out your application, send it to the address on the application. Do NOT send it to RxResource.
Eligibility:
To receive help from the BOTOX PATIENT ASSISTANCE™ Program, patients must: Be uninsured or underinsured, Have income less than or equal to 300% of the FPL, Have a medical diagnosis supported by clinical compendia, or Be a resident of the United States or Puerto Rico
To receive help from the BOTOX PATIENT ASSISTANCE™ Program, patients must: Be uninsured or underinsured, Have income less than or equal to 300% of the FPL, Have a medical diagnosis supported by clinical compendia, or Be a resident of the United States or Puerto Rico
Other Information:
Allergan is proud to assist eligible uninsured and underinsured patients with their treatment through the donation of BOTOX® vials. To apply for the program, patients or providers can visit www.BOTOXPatientAssistance.com to review the eligibility criteria and download the application. Or, for personal assistance with the application, patients or providers can call 1-800-44-BOTOX, Option 6.
Allergan is proud to assist eligible uninsured and underinsured patients with their treatment through the donation of BOTOX® vials. To apply for the program, patients or providers can visit www.BOTOXPatientAssistance.com to review the eligibility criteria and download the application. Or, for personal assistance with the application, patients or providers can call 1-800-44-BOTOX, Option 6.
Product(s) covered by program:
- BOTOX
