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

EstroGel Starter Units

For Healthcare Professionals Only

Provided by: ASCEND Therapeutics

Ascend Therapeutics
c/o SRF Processing,
607 Herndon Pkwy,
Herndon, VA 20170

TEL: 855-786-0738

ALT PHONE: 877-204-1013
FAX: 703-880-7484
Languages Spoken:


Program Website


Patient Assistance Applications

EstroGel Sample Request Form for Healthcare Professionals Only


Brand Name Medications Covered

  • EstroGel gel

Generic Name

  • estradiol gel

Eligibility Requirements   

Insurance Status Not specified
Those with Part D Eligible? Not specified
Income Not disclosed
Diagnosis/Medical Criteria Not specified
US Residency Required? Not specified


Obtaining Doctor/Doctor's office must call or download
Receiving Sent to Doctor's office
Returning Fax or mail from Doctor's office
Doctor's Action Complete section and sign
Applicant's Action Inform Doctor that he/she is in need
Decision Communicated Doctor notified
Decision Timeframe Not applicable


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


This company also provides copay assistance.

Updated February 23, 2018