| How to Apply
The Patient Access Network Foundation has established the
following funds to assist patients with the out-of-pocket costs
associated with the treatment within a variety of areas.
Would you like to apply for assistance?
or
If you are interested in applying for assistance within these
funded treatment areas, please call 1.866.316.PANF (7263). A Patient
Access Network Foundation counselor will work with you directly to
assist you in completing the application and assess your eligibility
for assistance. An application for assistance can be mailed or faxed
directly to you or your physician. Once completed, the application
can be mailed or faxed back to the Foundation at:
Patient Access Network Foundation
PO Box
221858
Charlotte NC 28222-1858
Fax:1.866.316.7261
To be eligible for assistance, patients must be U.S. residents
and meet certain financial, medical and insurance criteria as set by
the Foundation's board of directors. All applications must be
verified by patients and their physicians and be supported by
appropriate documentation as defined by each disease fund. Program
counselors will personally work with you to help you through the
application process.
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