Epilocker Patient Assistance Programs

Epilocker: Apply for prescription assistance below

If you are eligible, the programs below can help you afford EpiLocker. 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?

EpiPen4School Program

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

Provided by: Mylan Specialty
c/o BioRidge Pharma, LLC Attn: Kristina Paich
TEL: 973-845-7600
ALT PHONE: 973-845-7600
FAX: 973-718-4328
Languages Spoken:
English
Program Website
Medications
  • EpiLocker (epinephrine carton)
Eligibility Requirements
  • Insurance Status Not applicable
  • Those with Part D Elibible? Not applicable
  • Income Not applicable
  • Diagnosis/Medical Criteria Not disclosed
  • U.S. Residency Required? Must show residency in US
Application
  • Obtaining Call or download
  • Receiving Downloaded from website
  • Returning The completed application must be faxed back.
  • Doctor's Action Not applicable
  • Applicant's Action Not applicable
  • Decision Communicated Not specified
  • Decision Timeframe Not specified
Medication
  • Amount/Supply Varies
  • Sent To Varies. *see below for details
  • Delivery Time Not specified
  • Refill Proces Contact program for details.
  • Limit Varies
  • Re-application Contact program for details.
Additional Information
For grades K through 12 licensed as an educational facility under all applicable laws.
Updated November 7, 2018

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