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

Ferndale Laboratories Patient Assistance Program

This program provides brand name medications at no or low cost

Provided by: Ferndale Laboratories, Inc.

Customer Services
780 West Eight Mile Rd.
Ferndale, MI 48220

TEL: 800-621-6003

ALT PHONE: 248-548-0900
FAX: 248-548-0279
Languages Spoken:


Program Website


Program Applications and Forms

Ferndale Laboratories Patient Assistance Program Application



  • adhesive liquid (Mastisol) Liquid

Eligibility Requirements   

Insurance Status May have insurance
Those with Part D Eligible? Yes
Income At or below 100% of FPL
Diagnosis/Medical Criteria Medically appropriate condition/diagnosis
US Residency Required? Must be a citizen of the US and its Territories and be under the care of a US physician


Obtaining Call
Receiving Faxed, emailed or mailed
Returning Email, fax or mail
Doctor's Action Complete section, sign, attach prescription
Applicant's Action Complete section, sign, attach a copy of proof of income
Decision Communicated Patient notified
Decision Timeframe 7-10 business days


Amount/Supply Varies
Sent To Doctor's office or patient's home
Delivery Time Within 7-10 business days
Refill Process Patient or Doctor must contact company
Limit Contact the program for details
Re-application New application yearly

Additional Information

Eligibility determined on a case-by-case basis.

Updated February 16, 2021