Don't qualify for this program? Visit the DBAs to look for financial assistance based on your diagnosis.  

Botox Reimbursement Solutions (BRS)

For Healthcare Professionals Only

Provided by: Allergan, Inc.

PO Box 1370
San Bruno, CA 94066

TEL: Closed Program

ALT PHONE: 800-442-6869, opt. 4
FAX: 877-530-6680
Languages Spoken:



Patient Assistance Applications


Generic Name


Eligibility Requirements   

Insurance Status Not specified
Those with Part D Eligible? Not specified
Income Not disclosed
Diagnosis/Medical Criteria Not specified
US Residency Required? Must be residing in the US or Puerto Rico


Obtaining Doctor/Doctor's office must call or download
Receiving Faxed, mailed or downloaded from website
Returning Fax or mail from Doctor's office
Doctor's Action Varies
Applicant's Action Inform Doctor that he/she is in need
Decision Communicated Doctor notified
Decision Timeframe Not specified


Amount/Supply Not specified
Sent To Not specified
Delivery Time Not specified
Refill Process Not specified
Limit Not specified
Re-application Not specified

Additional Information

Closed Program

The Doctor must contact the program to place an order.

Updated March 12, 2018