More patients can now save on Gonal-f® (follitropin alfa for injection), Ovidrel® PreFilled Syringe (choriogonadotropin alfa injection), or Cetrotide® (cetrorelix acetate for injection). Eligible patients can use the Compassionate Care Program for multiple cycles within each year*
*Patients must reapply each year.
Click here to download the application form or call (855) 541-5926 to obtain the Compassionate Care enrollment forms.
Complete the Compassionate Care enrollment forms, patient authorization forms, and include the required income verification documents.
Patient’s can submit all of these documents via Mail, Fax or Email:
A. Mail to:
Compassionate Care Program
6501 Weston Parkway, Suite 370
Cary, NC 27513
B. Fax to: (919) 415-2870
C. Email to: firstname.lastname@example.org
Eligible patients will receive an e-mail and subsequent mailing with their Compassionate Care redemption card.
Present card along with prescription to a participating pharmacy and receive a discount off the cash price available at that pharmacy for the select medications. For more information about the Compassionate Care Program, please visit: www.FertilityLifelines.com