We are no longer accepting new enrollees in this program. Epileptic patients who are not currently enrolled and may need assistance, please download application or call 800.222.6885.

How to Apply

Please either download the application below (if available) or go to the program website for more information on how to apply. Once you fill out your application, send it to the address on the application. Remember not to send program applications to PPA.

Product(s) Covered by Program

  • D

    • Depakote® Sprinkle Capsules*
    • Depakote®*