Application Assistance

There are many local programs and individuals that help people use patient assistance programs. They help with such things as finding a program, completing the forms and working with physicians who must sign the forms.

Click on your state below to bring up a list of local programs.
Click on the name of the program for more information.

We need your assistance in finding these helpful programs. Please email us if you can help.

National Programs

Guam
Puerto Rico

If you or your organization helps people navigate the PAP system, send us your information so we can add you to this list. There are several ways to do this:

Complete an ONLINE FORM
Download an interactive PDF FORM to complete and mail.
Download a WORD FORM to complete and mail.

If you have changes or corrections concerning these programs, email us.