Seasonique Patient Assistance Program
Teva Women's Health,
Contact Information
Seasonique Patient Assistance Program
250 Phillips Blvd
Ste 250
Ewing, NJ 08618
1-(800) 425-3122 (phone)
1-(800) 685-2577 (fax)
Seasonique Patient Assistance Program
250 Phillips Blvd
Ste 250
Ewing, NJ 08618
1-(800) 425-3122 (phone)
1-(800) 685-2577 (fax)
Physician requests should be directed to:
1-(800) 425-3122 (phone)
1-(800) 425-3122 (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:
Must be a US resident, 18 years of age or older, gross annual household income must be at or below 200% of HHS Poverty Guidelines, no insurance (public or private) prescription drug coverage
Must be a US resident, 18 years of age or older, gross annual household income must be at or below 200% of HHS Poverty Guidelines, no insurance (public or private) prescription drug coverage
Other Information:
Patient must provide proof of income. Refill Policy: Requalification form should be requested and completed by healthcare professional. Re-Application Policy: New application every 12 months including financial documentation. Phone number operational Monday through Friday 8:30am until 5:30pm Eastern Standard Time.
Patient must provide proof of income. Refill Policy: Requalification form should be requested and completed by healthcare professional. Re-Application Policy: New application every 12 months including financial documentation. Phone number operational Monday through Friday 8:30am until 5:30pm Eastern Standard Time.
Product(s) covered by program:
- Seasonique™
