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Kaleo Cares Patient Assistance Program (Auvi-Q)

This program provides brand name medications at no or low cost

Provided by: Kaleo, Inc.

TEL: 877-302-8847

FAX: 800-943-1730
Languages Spoken:


Program Website


Program Applications and Forms

Kaleo Cares Patient Assistance Program Enrollment Form (Auvi-Q)

Kaleo Affordability Direct Delivery Service FAQ (Auvi-Q)

Kaleo Direct Delivery Service Patient Enrollment Form



  • Auvi-Q (epinephrine)

Eligibility Requirements   

Insurance Status Must be uninsured
Those with Part D Eligible? Varies
Income At or below 100% of FPL
Diagnosis/Medical Criteria FDA-approved diagnosis
US Residency Required? Must be US citizen or legal entrant


Obtaining Call or download
Receiving Faxed or downloaded from website
Returning Fax from Doctor's office
Doctor's Action Complete section, sign, attach required documents
Applicant's Action Complete section, sign, attach required documents
Decision Communicated Patient notified by phone
Decision Timeframe Not specified


Amount/Supply Varies
Sent To Patient's home
Delivery Time Within 48 hours
Refill Process Not specified
Limit Not specified
Re-application Not specified

Additional Information

Updated September 14, 2018