Auvi-Q Patient Assistance Programs

Auvi-Q: Apply for prescription assistance below

If you are eligible, the programs below can help you afford Auvi-Q. Review the information to see if you qualify. The applications are available in Adobe PDF format and should be mailed directly to the provider of the patient assistance program.

If you have any questions, please call the telephone number for the program (not PharmacyChecker.com) or go to the program website.

Looking for a different medication?

Kaleo Cares Patient Assistance Program (Auvi-Q)

(Program 1 of 1 — Scroll down to see them all )

Provided by: Kaleo, Inc.
None
TEL: 877-302-8847
FAX: 800-943-1730
Languages Spoken:
English, Spanish
Program Website
Medications
  • Auvi-Q (epinephrine)
Eligibility Requirements
  • Insurance Status Must be uninsured
  • Those with Part D Elibible? No
  • Income Gross annual household income at or below $100,000
  • Diagnosis/Medical Criteria FDA-approved diagnosis
  • U.S. Residency Required? The patient must be a US citizen or legal entrant.
Application
  • Obtaining Call or download
  • Receiving Faxed or downloaded from website
  • Returning The completed application should be faxed back from the 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
Medication
  • Amount/Supply Varies
  • Sent To Patient's home
  • Delivery Time Within 48 hours
  • Refill Proces Contact program for details.
  • Limit Contact the program for details
  • Re-application New application every 12 months
Additional Information
None
Updated October 29, 2018

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