North Dakota AIDS Drug Assistance Program

North Dakota

Contact Information
Ryan White Title II/ADAP Coordinator, ND State Dept. of Health, Division of Disease Control
600 East Boulevard Avenue
Dept. 301
Bismark, ND 58505-0200
1-(800) 472-2180 (phone)
1-800-472-2180 (vanity_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.
  • Click here to visit the program's web site.
    • Eligibility:
    ATTENTION: YOU MUST BE HIV POSITIVE TO BE ELIGIBLE FOR THIS PROGRAM. Must be HIV+. Must be a North Dakota resident for at least 30 days. Must apply to Medicaid first, then present denial letter (if denied). Must have proof of income and receipt of other services (Medicaid, Medicare, private insurance, etc.) or lack thereof. If you do have health insurance, this program may be able to help with co-pay.
    Product(s) covered by program:
    • 3TC
    • Agenerase®
    • Albenza®
    • Aminosidine
    • Amoxil®
    • AMS
    • Ativan
    • Avo-Sulfon
    • Avosulfon®
    • AZT
    • Bactrim
    • Bactrim DS
    • Biaxin® Filmtab
    • Biaxin® Granules
    • Biaxin® XL Filmtab
    • Biaxin® XL Pac
    • Cardura®
    • Cipro
    • Cipro HC Otic
    • Cipro I.V.
    • Cipro® Oral Suspension
    • Cipro® tablets
    • Cipro® XR
    • Cleocin
    • Cleocin Pediatric Oral Susp®
    • Cleocin Phosphate
    • Cleocin T®
    • Cleocin Vaginal Cream/Ovules®
    • Combivir®
    • Compazine
    • Crixivan®
    • Cytovene
    • d4T
    • Dapsone
    • Daraprim®
    • Darvocet A500™
    • Darvocet-N
    • ddC
    • ddI
    • DDS
    • Deltasone
    • Desyrel
    • Diflucan®
    • Diflucan® Suspension
    • Duramorph
    • EES
    • Effexor
    • Effexor Tablets
    • Effexor XR Extended-Release Capsules
    • Elavil
    • Epivir®
    • Epivir-HBV®
    • EPOGEN®
    • ERY-TAB
    • Erythrocin Stearate Filmtab Tablet
    • Erythromycin Base Filmtab Tablet
    • Famvir®
    • Florinef
    • Fortovase
    • Foscavir
    • Fungizone
    • Haldol®
    • Haldol® Dec
    • Havrix
    • Hep-B Gammagee
    • Hepsera
    • HIVID
    • Humatin
    • Hydrea
    • Imodium
    • Influenza
    • Influenza Vaccine
    • Influenza Virus Vaccine
    • Invirase
    • Kaletra®
    • Kaletra® Oral Solution
    • Lipitor®
    • Liquid Pred
    • Lodine Capsules
    • Lodine XL Tablets
    • Lomotil®
    • Lotrimin
    • Marinol
    • Megace
    • Megace Oral Suspension
    • Mepron®
    • Meticorten
    • Metocorten
    • Microsulfon
    • MS Contin
    • Myambutol
    • Mycelex®
    • Mycelex® Troche
    • Mycelex-G
    • Mycobutin®
    • Mycostatin
    • NebuPent
    • NebuPent Inhalation Solution
    • Nephrocap
    • Neupogen
    • Neurontin®
    • Nizoral®
    • Norvir® Oral Solution
    • Norvir® Soft Gelatin Capsules
    • Oramorph
    • OramorphSR
    • Orasone
    • Panasol
    • Pentacarinat
    • Peridex
    • PhosLo
    • Pneumovax
    • Pneumovax 23
    • Pnu-Immune
    • Prednicen-M
    • Prednisone tablet
    • PROCRIT
    • Protonix Tablets
    • Prozac Weekly®
    • Prozac®
    • Relenza®
    • Rescriptor®
    • Retrovir®
    • Reyataz
    • Roxanol
    • Septra
    • Sporanox®
    • Sporanox® Oral Solution
    • Sterapred
    • Sterapred DS
    • Sulfadiazine Tablets
    • Sustiva
    • Symbyax™
    • Symmetrel
    • Trizivir®
    • Tylenol 3
    • Valcyte
    • Videx
    • Videx EC
    • Videx Pediatrics
    • Viracept®
    • Viramune
    • Viramune® Oral Suspension
    • Viramune® Tablets
    • Viread
    • Vistide
    • Wellcovorin
    • Zantac®
    • Zerit®
    • Zestril® Tablets
    • Ziagen®
    • Zithromax®
    • Zithromax® Suspension
    • Zithromax® Tri-Pak
    • Zithromax® Z-Pak
    • Zofran ODT
    • Zofran®
    • Zoloft®
    • Zovirax®
    • Zyprexa®