This program provides certain Forest products to patients who are unable to afford the cost of their medication and who meet other eligibility requirements. Eligibility for this program is based upon information you and your licensed practitioner provide on the application form. If you are approved, you will receive a three-month supply of the Forest product you require at no charge. Forest will ship your medication to your licensed practitioner's office for them to dispense to you.

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

  • A

    • AeroBid®
    • Armour® Thyroid
  • C

    • Campral
    • Celexa
  • E

    • Esgic
  • F

    • Fetzima®
  • K

    • Kay Ciel
  • L

    • Levoxyl®
    • Lexapro®
    • Linzess® Capsules
  • N

    • Namenda®
    • Nitrogard
  • S

    • Savella®
  • T

    • Theochron
    • Thyrolar
    • Tiazac®
    • TUDORZA® PRESSAIR® (aclidinium bromide inhalation powder) 400mcg
  • V

    • Viibryd®