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Klonopin

Pharmaceutical Company Roche Labs
Program Address Medical Needs Program
340 Kingsland St.
Nutley, NJ 07110-1199
 Toll Free Phone Number 800-285-4484
Alternate Phone Number 800-526-6367, 800-534-9696
Fax Number None
Guidelines and Notes

Special products:

CellCept (800-772-5790)
Cytovene (800-282-7780, prompt #1)
HIVID (800-285-4484 (prompt #2)
Invirase (800-282-7780)
Roferon-A (800-443-6676)
Call bewteen 9:00 A.M. and 4:00 P.M. Eastern time.

The program are not intended for clinics, hospitals, or institutions. Patients should be ineligible for any type of prescription coverage. They will only send the application to the doctor's office and the form can't be copied.

Initiating Enrollment The form is sent to the doctor for completion. The physician's office or a social worker may call.
Health Provider's Role The doctor completes and signs the form and includes his/her DEA number. No written prescription is needed.
Patient's Role Minimal information is required - they will have most of it on file. The patient's signature is required.
How Dispensed The medicine is sent to the address on the doctor's DEA license.
Amount Dispensed 3 months
Estimated Response Time 3 - 4 weeks
Refills Use a new application.
Limit Indefinite.

Updated on: 8/21/99