Trulance patient assistance program

Your monthly Trulance cost savings if eligible. If you are eligible for the Trulance patient assistance program, the cost of your medication will be free. We only charge $49 a month, per medication, to cover our service fees. You could receive your Trulance prescription for just $49 a month, regardless of the retail price of your medication.

Trulance patient assistance program. Currently, there is no generic for Trulance. However, GoodRx coupons, manufacturer copay cards, and patient assistance programs can help offset your cost. How can I save on …

To do so, there are a few steps that their healthcare provider needs to take: Call the GSK patient assistance program at 866‑728‑4368 to see whether their …

Trulance can help, but paying for it for to indefinite range of time can be beyond a patient’s accomplish, and the ensuing underline able exacerbate symptoms. Patient Assist Program Application Simplefill addresses such dispute by raising public mental via prescription helps and making connections zwischen subject who need help paying with ...Application for Free AstraZeneca Medicines Page 3 of 5 Questions? Call 1-800-292-6363 Monday–Friday, 9:00 am to 6:00 pm EST or visit www.azandmeapp.com Non-Specialty Products Fax: 1-800-961-8323 PATIENT INFORMATION: Please print clearly in blue or black ink. Asterisks indicate required fields.U.S. Assistance Programs. Bausch Health is dedicated to discovering and delivering new therapies to improve patient health. Whether by providing patients with health information related to our products, supporting medical and scientific educational programs, or making sure that those in need have access to our medicines, everything we do is ...Get Help Paying for Prescriptions. Our Prescription Assistance Program is a community benefit to help our uninsured or underinsured patients receive medications through pharmaceutical companies. Pharmaceutical companies supply some of the medications they produce at reduced or no cost to patients in need. The Prescription Assistance Program ...MerckHelps™ is the name for our suite of patient assistance programs offered by the Merck Patient Assistance Program, Inc. These programs provide certain Merck medicines and adult vaccines free of charge to people who do not have prescription drug or health insurance coverage and who, without our assistance, cannot afford their Merck ...Medicine Matters Sharing successes, challenges and daily happenings in the Department of Medicine Award Amount: $495,000 Funding Term: 3 years Due Date: November 13, 2020 (Pre-Prop... Contact us If you have questions, concerns, or comments, we’d like to hear from you. To get in touch with us, please call our medical information number toll-free at 1-888-869-8869. BI Cares Patient Assistance Program Phone: 1-800-556-8317 P.O. Box 5520, Louisville, KY 40255 Fax: 1-866-851-2827 1. Application Page of . 4. Section 1: Patient Information . First Name: Last Name: Address: City: State: Zip Code: Note: Delivery will be to patient’s address unless otherwise indicated by the patient. ...

It depends on which coverage stage you are in. Click on a tab below…. Deductible. Post-Deductible. Donut Hole. Post-Donut Hole. Copay Range. $7 – $642. After your deductible has been satisfied, you will enter the Post-Deductible (also called Initial Coverage) stage, where you pay your copay and your plan covers the rest of the drug cost. Trulance can help you have: MORE regular, well-formed bowel movements* LESS IBS-C–related stomach pain and bloating †. LOW incidence of diarrhea. *In a clinical trial vs placebo. † Stomach symptoms including bloating were studied in combination, not individually. Read the recommendation for Trulance. TALK TO A DOCTOR NOW Take the next step. merck patient assistance program enrollment form *you do not have to be a us citizen m m d d y y y y sign patient’s original signature _____ date patient must complete this side of form and sign in both places with a section 1: complete the patient information below. please print in legible capital letters. m m d d y y y y Roadside assistance programs are very popular among American consumers. After all, there are nearly 110 million cars driving on highways in the United States, the home of the road ...Maximum savings per fill is $800.00 for ARISTADA 441 mg, 662 mg, and 882 mg, up to 12 fills per calendar year, with maximum savings up to $7600 per calendar year. Maximum savings per fill is $1600.00 for ARISTADA 1064 mg, up to 6 fills per calendar year, with maximum savings up to $7600 per calendar year. Minimum out-of-pocket cost per fill ...The patient is not eligible to use this copay savings card if they are enrolled in a state or federally funded prescription insurance program, including, but not limited to, Medicare, Medicaid, TRICARE, Veterans Affairs health care, a state prescription drug assistance program, or the Government Health Insurance Plan available in Puerto Rico (formerly …Ways to save on Trulance These programs and tips can help make your prescription more affordable. ... However, GoodRx coupons, manufacturer copay cards, and patient assistance programs can help offset your cost. How can I save on Trulance? expand_more. There are a few ways to save on Trulance. GoodRx coupons can help …What are the common side effects of Trulance? Diarrhea is the most common side effect and can sometimes be severe. Diarrhea often begins within the first 4 weeks of Trulance treatment. Stop taking Trulance and call your doctor right away if you get severe diarrhea. These are not all the possible side effects of Trulance.

Support specialists your patient can count on. When you prescribe a Takeda treatment, our support specialists are dedicated to helping your patient get the answers, resources, and tools they need. Our services include benefits investigation and prior authorization (PA), reauthorization, and appeals education.Bausch Health understands that multiple patients may face financial obstacles that can keep diehards from obtaining the prescription products they need. Bausch Health is commited to improving access to medications through willingness patient assistance programs. These programs are listed below: Bausch Health My Customer Program » …As people age, their financial resources can become limited. This can make it difficult for senior citizens to afford the food they need to stay healthy. Fortunately, there are a n...Patient assistance programs offered by drug manufacturers can help you save money on your prescriptions. Many drug manufacturers have such a program, offering discounts to eligible patients who are prescribed Trulance. Patients prescribed expensive or branded medication may qualify for discounts through such programs.TRULANCE® is a guanylate cyclase-C agonist, which mimics the effect of natural hormones in the body, giving it a unique method of action which allows it to act in the small intestine in a pH-sensitive manner to facilitate fluid secretion, increase intestinal transit, and decrease the activity of pain-sensitive nerves in the intestines. 14 In ...REFERENCES. 1. Bausch Health, Canada, Understanding Patients’ Perceptions and Treatment Habits of IBS-C, research report by Callosum, October 2021, p.15. 2. Bausch Health, Canada, TRULANCE Product Monograph dated March 17, 2021, Indications, p. 4. 3. Moayyedi P et al, Canadian Association of Gastroenterology Clinical …

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Since the program’s inception, the Takeda Help at Hand Patient Assistance Program has provided free medication to more than 100,000 patients who were facing financial hardship. Learn more about the Help at Hand program. Disclaimer: This information is only for products listed here. Takeda has other patient support programs. If you have any questions, visit the FAQs or call us at 1-800-222-6885. AbbVie is committed to helping patients get the medicines they need. That’s why we offer patient assistance programs that provide free AbbVie medicines to qualifying patients. Our Patient Assistance Programs are intended for people that live in the United States, have ...Nursing assistants are an important part of the healthcare system. They work under the guidance of licensed or registered nurses and help with tasks like patient hygiene, mobility,...The Lilly Cares Foundation, Inc. (“Lilly Cares”) is a nonprofit organization that offers the Lilly Cares Patient Assistance Program (“Program”) to help qualifying patients obtain certain Eli Lilly and Company medications at no cost.Trulance® is contraindicated in patients less than 6 years of age; in nonclinical studies in young juvenile mice administration of a single oral dose of plecanatide caused deaths due to dehydration. Use of Trulance should be avoided in patients 6 …Meet MAT, the Medicine Assistance Tool. PhRMA’s Medicine Assistance Tool (MAT) is a search engine designed to help patients, caregivers and health care providers learn more about the resources available through the various biopharmaceutical industry programs. MAT is not its own patient assistance program, but rather a search engine for many ...

U.S. Assistance Programs. Bausch Health is dedicated to discovering and delivering new therapies to improve patient health. Whether by providing patients with health information related to our products, supporting medical and scientific educational programs, or making sure that those in need have access to our medicines, everything we do is ...TRULANCE is contraindicated in patients less than 6 years of age. The safety and effectiveness of TRULANCE in patients less than 18 years of age have not been established. In young juvenile mice (human age equivalent of approximately 1 month to less than 2 years), plecanatide increased fluid-secretion into the intestines as a consequence ofGetting started with myAbbVie Assist Patient Assistance Program enrollment is easy. AbbVie is committed to helping patients get the medicines they need. myAbbVie Assist is intended for people who have limited or no health insurance coverage and demonstrate qualifying financial need. This form can be submitted online or by faxing to 1-800-276-9901. By clicking SUBMIT and activating a Trulance Savings Card, I confirm that I have read and understood the Eligibility Criteria and Terms and Conditions contained above, and that the patient who will use the savings card meets all eligibility criteria and will comply with all terms and conditions of the program. BI Cares Patient Assistance Program Phone: 1-800-556-8317 P.O. Box 5520, Louisville, KY 40255 Fax: 1-866-851-2827 Application Page 1 of 4. Section 1: Patient Information . First Name: Last Name: Address: City: State: Zip Code: Note: Delivery will be to patient’s address unless otherwise indicated by the patient. Aptivus ® will be shipped to ... Get the free trulance patient assistance application form. Get Form. Show details. We are not affiliated with any brand or entity on this form. 4,4. 98,753 Reviews. 4,5. 11,210 … Diarrhea. Diarrhea was the most common adverse reaction in the four placebo-controlled clinical trials for CIC and IBS-C. Severe diarrhea was reported in 0.6% of Trulance-treated CIC patients, and in 1% of Trulance-treated IBS-C patients. If severe diarrhea occurs, the health care provider should suspend dosing and rehydrate the patient. In the final stage of Parkinson’s disease, patients are unable to perform basic movements without assistance and require one-on-one care, according to Healthline. Trulance can help you have: MORE regular, well-formed bowel movements* LESS IBS-C–related stomach pain and bloating †. LOW incidence of diarrhea. *In a clinical trial vs placebo. † Stomach symptoms including bloating were studied in combination, not individually. Read the recommendation for Trulance. TALK TO A DOCTOR NOW Take the next step.

By using the Pfizer Dermatology Patient Access TM Copay Savings Card, you acknowledge that you currently meet the eligibility criteria and will comply with the terms and conditions described below: . You are not eligible to use this card if you are enrolled in a state or federally funded prescription insurance program, including but not limited to Medicare, …

Salix offers a patient assistance program for TRULANCE and other medications, including CYCLOSET, PLENVU, RELISTOR, and UCERIS. Learn how to apply for the program, access resources, and find support from Salix and HCPs. About Trulance. Managing irritable bowel syndrome with constipation (IBS-C) or chronic idiopathic constipation (CIC) can be a challenge. But whether you’ve just been diagnosed with IBS-C or CIC or have been dealing with it for a while, one thing is for sure: when managing constipation, your goal should be more regular, well-formed bowel movements with less IBS-C–related stomach pain and ... Our prescription advocacy program is designed for patients just like you. By utilizing patient assistance programs, many people are eligible for financial help because of their yearly income. Has your doctor prescribed either Linzess or Trulance to treat your medical condition? The Takeda Patient Support Co-Pay Assistance Program can help eligible, commercially insured patients save on their prescribed Takeda treatment.* The program can cover up to 100% of your patient’s out-of-pocket co-pay costs. To be eligible for this program, your patient must: Be prescribed a Takeda treatment for a Food and Drug Administration ... Aug 24, 2023 · When you choose to receive Trulance patient assistance through The Rx Advocates, you will only pay us a fixed monthly fee of $80/month. This fee may vary depending on the number of medications that you require: 1 Medication (Trulance Only) – Fixed cost of $80 per month. 2 Medications (Trulance + 1 other) – Fixed cost of $90 per month. Must be 18 years of age or older and under the age of 65 to participate in the program. Commercially insured patients may pay as little as $25 per prescription fill of Trulance, for up to 12 offers per year. To qualify for this offer, the patient’s out-of-pocket expense must be a minimum of $25 per prescription.By clicking SUBMIT and activating a Trulance Savings Card, I confirm that I have read and understood the Eligibility Criteria and Terms and Conditions contained above, and that the patient who will use the savings card meets all eligibility criteria and will comply with all terms and conditions of the program.In today’s fast-paced and stressful work environment, employers are increasingly concerned about the well-being of their employees. One way employers can support their staff is thr...

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Ways to save on Trulance These programs and tips can help make your prescription more affordable. ... However, GoodRx coupons, manufacturer copay cards, and patient assistance programs can help offset your cost. How can I save on Trulance? expand_more. There are a few ways to save on Trulance. GoodRx coupons can help …Applying to myAbbVie Assist is simple. It is free to apply, and those who qualify will receive their medicine for free — no co-pays or shipping costs. Check Eligibility by visiting the myAbbVie Assist page. Contact for Medical Information: 844-663-3742. Learn about myAbbVie Assist, a patient assistance program from AbbVie. This program helps ... PATIENT ASSISTANCE PROGRAM (PAP) APPLICATION FOR Trulance (plecanatide) Fax: 18446273827 Phone: 18447963757PROGRAM OVERVIEW The Trulance Patient Assistance Program (PAP) is designed to provide Trulance. Ibsrela Commercial Copay Program. Eligible commercially insured patients may pay $0 per 30-day supply with a savings of $1786 per fill; for additional information contact the program at 877-274-3244. Applies to: Ibsrela Number of uses: Per prescription until program expires. Form more information phone: 877-274-3244 or Visit websiteIt is a quick call and depending on your situation, it could save you thousands on your medications. 1-877-386-0206. To determine if a patient is eligible for assistance, Simplefill conducts an in-depth interview over the phone with a trained specialist. If a patient is qualified for any type of assistance, the Simplefill team manages the ...It depends on which coverage stage you are in. Click on a tab below…. Deductible. Post-Deductible. Donut Hole. Post-Donut Hole. Copay Range. $7 – $642. After your deductible has been satisfied, you will enter the Post-Deductible (also called Initial Coverage) stage, where you pay your copay and your plan covers the rest of the drug cost.CIC and IBS-C. Severe diarrhea was reported in 0.6% of Trulance-treated CIC patients, and in 1% of Trulance-treated IBS-C patients. • If severe diarrhea occurs, the health care provider should suspend dosing and rehydrate the patient. Adverse Reactions • In the two combined CIC clinical trials, the most common adverse reaction in Trulance ...If you are considering a career in healthcare, becoming a certified nursing assistant (CNA) can be a great starting point. CNA classes provide aspiring healthcare professionals wit...Trulance Prices, Coupons and Patient Assistance Programs. Trulance (plecanatide) is a community of the guanylate cyclase-C antagonists drug class or is commonly used for Chronic Idiopathic Constipation, and Irritable Bowel Syndrome with Constipation.. The cost for Trulance oral tablet 3 grams is around $545 for a supply the 30 tablets, depending for …TRULANCE is contraindicated in patients less than 6 years of age; in nonclinical studies in young juvenile mice administration of a single oral dose of plecanatide caused deaths due to dehydration [see Contraindications (4), Use in Specific Populations (8.4)]. • Avoid use of TRULANCE in patients 6 years to less than 18 years of age [see ...Patient Access Network Foundation https://www.panfoundation.org OR by phone: 1-866-316-7263 Open intermittently, “first come -first serve” basisCall 1-800-226-2056 to speak with a program specialist. We are available Monday through Friday, 9 AM to 8 PM ET. Please let us know if English is not your preferred language. Learn about support offerings for Gilead medication and educational resources to help your patients access their Gilead medication. ….

Bausch Health understands that some patients may face financial obstacles that can keep them from obtaining the prescription products they need. Bausch Health is committed to improving access to medications through our patient assistance programs. These programs are listed below: Bausch Health Patient Assistance Program ». (833) 862-8727.Trulance can help, but paying for it for an indefinite period of time can be outside a patient’s contact, and the resulting stress pot tighten symptoms. Simplefill addresses that challenge by raising public awareness about prescription assistance the making connections between patient who need help paying for costly prescriptions and the ...1-800-721-5072. (toll free U.S. only) As of 2019, Bristol Myers Squibb and Celgene have merged. If you or someone you know have possibly experienced a side effect or have a product complaint while taking a legacy Celgene product, please contact us. …Roadside assistance programs are very popular among American consumers. After all, there are nearly 110 million cars driving on highways in the United States, the home of the road ... U.S. Assistance Programs. Bausch Health is dedicated to discovering and delivering new therapies to improve patient health. Whether by providing patients with health information related to our products, supporting medical and scientific educational programs, or making sure that those in need have access to our medicines, everything we do is ... By using the Pfizer Dermatology Patient Access TM Copay Savings Card, you acknowledge that you currently meet the eligibility criteria and will comply with the terms and conditions described below: . You are not eligible to use this card if you are enrolled in a state or federally funded prescription insurance program, including but not limited to Medicare, …financial assistance options for eligible patients, if needed 3 Financial Assistance Options Our Patient Support Managers will review your patient’s coverage and help them understand what financial options may be available. Quick Start Program: Helps patients who are experiencing insurance delays get immediate access to LIVTENCITY® … PATIENT ASSISTANCE PROGRAM (PAP) APPLICATION FOR Trulance (plecanatide) Fax: 18446273827 Phone: 18447963757PROGRAM OVERVIEW The Trulance Patient Assistance Program (PAP) is designed to provide Trulance. Trulance patient assistance program, Subject to the Gilead Advancing Access® Co-pay Coupon (“Coupon”) Terms and Conditions, this program provides the following financial assistance for the out-of-pocket costs for eligible commercially insured patients with a valid prescription: Up to $9,600 in cost-sharing assistance per calendar year with no monthly limit for the following ..., Diarrhea. Diarrhea was the most common adverse reaction in the four placebo-controlled clinical trials for CIC and IBS-C. Severe diarrhea was reported in 0.6% of Trulance-treated CIC patients, and in 1% of Trulance-treated IBS-C patients. If severe diarrhea occurs, the health care provider should suspend dosing and rehydrate the patient., Patient Application for XELJANZ® XR (tofacitinib) extended release tablets/XELJANZ® (tofacitinib) tablets. Phone 1-844-XELJANZ (1-844-935-5269) • Fax 1-866-297-3471 • 2730 S. Edmonds Lane, Suite 300, Lewisville, TX 75067. . Please complete the form where applicable and return via mail or fax. Pages 1 and 3 must be returned to XELSOURCE., Salix Pharmaceuticals is the manufacturer of Trulance. Currently, they offer a Trulance savings card that lets eligible patients purchase Trulance at a discounted price. Eligible patients can also benefit from Trulance patient assistance programs provided by the Bausch Health Patient Assistance Program and the Trulance Access Services., Patient Assistance Program. The Novo Nordisk Patient Assistance Program (PAP) is based on our commitment to people living with diabetes. The Novo Nordisk PAP provides medication at no cost to those who qualify. There is no registration charge or monthly fee for participating. Click here for a list of Novo Nordisk products covered by the PAP., The Department of Health and Human Services (DHHS) is a government agency that provides assistance to people in need. The DHHS program offers a wide range of services, from health ..., Aug 24, 2023 · When you choose to receive Trulance patient assistance through The Rx Advocates, you will only pay us a fixed monthly fee of $80/month. This fee may vary depending on the number of medications that you require: 1 Medication (Trulance Only) – Fixed cost of $80 per month. 2 Medications (Trulance + 1 other) – Fixed cost of $90 per month. , Pfizer Oncology Together TM is a personalized patient support program to help you and your caregiver throughout IBRANCE treatment. If needed, we can work with you to help identify financial assistance options for your prescribed IBRANCE. And if you need help with some of the day-to-day challenges you're facing, we can connect you to a dedicated …, ArdelyxAssist offers additional programs for eligible patients who are uninsured or underinsured and are unable to afford IBSRELA. ArdelyxAssist ™ is here to help. Call us at 844-427-7352, option 1 if you have any questions or need support with IBSRELA access or affordability. To fax a prescription: (877) 765-7664. * Terms and conditions apply., Join 1.5 million Canadians already saving and get your card today. The innoviCares card is a free prescription savings card available to all Canadian residents, and is funded by participating pharmaceutical manufacturers. Present your innoviCares card at your pharmacy and ask for the brand-name medication. Your card will automatically cover a ..., TRULANCE® is a guanylate cyclase-C agonist, which mimics the effect of natural hormones in the body, giving it a unique method of action which allows it to act in the small intestine in a pH-sensitive manner to facilitate fluid secretion, increase intestinal transit, and decrease the activity of pain-sensitive nerves in the intestines. 14 In ..., Texas residents who are struggling to pay their utility bills can access a variety of assistance programs. These programs provide financial assistance and other resources to help T..., If you have any questions, visit the FAQs or call us at 1-800-222-6885. AbbVie is committed to helping patients get the medicines they need. That’s why we offer patient assistance programs that provide free AbbVie medicines to qualifying patients. Our Patient Assistance Programs are intended for people that live in the United States, have ... , 01. Edit your salix pharmaceuticals patient assistance program online. Type text, add images, blackout confidential details, add comments, highlights and more. 02. Sign it in a few clicks. Draw your signature, type it, upload its image, or use your mobile device as a signature pad. 03., Our assistance programs help patients access the medicines they need to see and feel better and deliver on our promise of providing pioneering, compassionate care. We offer assistance to those undergoing financial and/or insurance hardships that prevent them from obtaining our prescription products. Call 1-855-770-0424 between 8 am – 5 pm EST ..., COPD: TRELEGY 100/62.5/25 is for maintenance treatment of patients with chronic obstructive pulmonary disease (COPD). Asthma: TRELEGY is for maintenance treatment of adults with asthma. Limitations of Use: TRELEGY is NOT for the relief of acute bronchospasm. Find tools you can share with your COPD and asthma patients, including links and ..., If you are considering a career in healthcare, becoming a certified nursing assistant (CNA) can be a great starting point. CNA classes provide aspiring healthcare professionals wit..., For more information, dial 1‑844‑DUPIXENT( 1-844-387-4936), option 1 Monday-Friday, 8 am-9 pm ET. DUPIXENT MyWay® is a patient support program designed to assist with access to DUPIXENT® (dupilumab) while providing useful tools and resources. DUPIXENT® is a prescription medicine FDA-approved to treat five conditions., This offer is not valid where otherwise prohibited, taxed, or otherwise restricted. Patient is responsible for reporting receipt of co-pay assistance to any insurer, health plan, or other third party who pays for or reimburses any part of the prescription filled using the co-pay card, as may be required., The Card is not valid for prescriptions that are eligible to be reimbursed, in whole or in part, by Medicaid, Medicare (including Medicare Part D), or other federal or state healthcare programs (including any state prescription drug assistance programs and the Government Health Insurance Plan available in Puerto Rico [formerly known as “La ..., There are a few ways to save on Trulance. GoodRx coupons can help lower the price to $567.87 per fill. Additionally, manufacturer Salix Pharmaceuticals offers a Manufacturer Coupon where commercially insured patients may receive their prescription at $25.00., Add the Bausch patient assistance program application pdf for editing. Click on the New Document option above, then drag and drop the document to the upload area, import it from the cloud, or using a link. Alter your file. Make any adjustments needed: insert text and pictures to your Bausch patient assistance program application pdf, highlight ..., In today’s challenging economic climate, many families find it difficult to make ends meet. For those with low incomes, paying for housing can be an overwhelming burden. Thankfully..., The Takeda Patient Support Co-Pay Assistance Program can help eligible, commercially insured patients save on their prescribed Takeda treatment.* The program can cover up to 100% of your patient’s out-of-pocket co-pay costs. To be eligible for this program, your patient must: Be prescribed a Takeda treatment for a Food and Drug Administration ..., Must be 18 years of age or older and under the age of 65 to participate in the program. Commercially insured patients may pay as little as $25 per prescription fill of Trulance, for up to 12 offers per year. To qualify for this offer, the patient’s out-of-pocket expense must be a minimum of $25 per prescription., The purpose of the Bausch Health Patient Assistance Program is to help those eligible patients who are prescribed certain Bausch Health Companies, Inc products obtain those products although financial circumstances or insurance status may otherwise interfere with the ability to do so., The Card is not valid for prescriptions that are eligible to be reimbursed, in whole or in part, by Medicaid, Medicare (including Medicare Part D), or other federal or state healthcare programs (including any state prescription drug assistance programs and the Government Health Insurance Plan available in Puerto Rico [formerly known as “La ..., Salix offers a patient assistance program for TRULANCE and other medications, including CYCLOSET, PLENVU, RELISTOR, and UCERIS. Learn how to apply for the program, …, We are here to help. Our prescription advocacy program is designed for patients just like you. By utilizing patient assistance programs, many people are eligible for financial help because of their yearly income. Has your doctor prescribed either Linzess or Trulance to treat your medical condition? Are you finding the cost a burden?, Salix offers a patient assistance program for TRULANCE and other medications, including CYCLOSET, PLENVU, RELISTOR, and UCERIS. Learn how to apply for the program, access resources, and find support from Salix and HCPs. , Call 1-800-830-9159 if you need help. Help At Hand representatives are available Monday through Friday, 8:00 a.m. to 8:00 p.m. ET. Page 2 of 5. PLEASE PRINT CLEARLY IN BLACK OR BLUE INK. Red boxes signify required fields. Call 1-800-830-9159 if you need help. Application type: Initial. Renewal., For questions, please contact the Salix Patient Assistance Program at 1-866-282-6563. 2. Include State License or NPI Number. 2. Complete the Financial Information (Section IV) including: Total assets (i.e., cash, bank accounts, money market or cash holdings). Do not include values of real estate, cars, or personal belongings. 3. , Not every Bausch Health prescription product is included in the Bausch Health Patient Assistance Program. The Bausch Health Patient Assistance Program is also subject to change at any time without prior notification. Call us at 833-862-8727, 8 AM to 5 PM ET for more information.