Program Contact Info / Application Submission
Program	Valeant Patient Assistance Program
Company	Valeant Pharmaceuticals International
Form	Download PDF
Address	P.O. Box 42886 Cincinnati, OH 45242
Phone	866-268-7325
Fax	866-217-7164
Website	http://www.valeant.com/about/programs/patient-assistance-program.jsp
Program Requirements
Details	Insurance card required Drivers license required
Delivery of Medication
Ship Time	7 - 10 business days
Delivery Options	Can be delivered directly to the patient Can NOT be delivered directly to the doctor Shipped as a voucher card
Application Process
New Applications	New applications NOT accepted Patients can NOT apply directly to the program Doctors can NOT apply directly to the program Advocates can NOT apply directly to the program Can apply for a new application via phone Can NOT apply for a new application via fax Can apply for a new application via mail
Refills	Refills NOT accepted Patients can NOT apply for refills Doctors can NOT apply for refills Advocates can NOT apply for refills Can apply for refills via phone Can NOT apply for refills via fax Can apply for refills via mail
Re-Applications	Re-Applications NOT accepted Patients can NOT apply for Re-Applications Doctors can NOT apply for Re-Applications Advocates can NOT apply for Re-Applications Can Re-Apply via phone Can NOT Re-Apply via fax Can Re-Apply via mail
Other Medications
Other  Medications  available in  this program	Zovirax cream 2 grams - Herpes Antiviral (Generic: acyclovir) Zovirax ointment 15 grams - Herpes Antiviral (Generic: ) Cuprimine 250mg - Rheumatoid Arthritis (Generic: penicillamine capsules) Demser 250mg - adrenal gland tumor Glands (Generic: metyrosine) Lacrisert Ophthalmic insert 5mg - lubricant Eye (Generic: hydroxypropyl cellulose) Mephyton 5mg - Vitamin K Supplement (Generic: phytonadione) Diastat Acudial 10mg - anticonvulsant Neuro/ Mental Health (Generic: ) Migranal Nasal Spray - Migraine (Generic: dihydroergotamine mesylate+ caffeine) Diastat Gel 2.5mg - antianxiety Neuro/ Mental Health (Generic: ) Ancobon Capsules 500mg - Antifungal Combo Anti-infective (Generic: ) Mestinon Timespan Tablets, 180 mg - Myasthenia Gravis Neuro/ Mental Health (Generic: ) Tasmar Tablets 200mg - Parkinsons Disease Neuro/ Mental Health (Generic: ) Oxsoralen Ultra-Capsules 10mg - Skin (Generic: ) Prostigmin Tablets, 15mg - Myasthenia Gravis Pigment (Generic: ) Zelapar 1.25mg - Parkinsons Neuro/ Mental Health (Generic: ) Diastat Acudial 20mg - (Generic: ) Tasmar Tablets 100mg - (Generic: ) Edecrin 25mg - (Generic: ) Syprine 250mg - (Generic: ) Timoptic Ocudose 0.25% - (Generic: ) Timoptic Ocudose 0.50% - (Generic: )