Vyvanse assistance program canada 2025

1. Click ‘Get Form’ to open the vyvanse assistance program application in the editor.
2. In Sections 1 and 2, your physician should complete all fields clearly, including patient information and treatment details. Ensure they sign and date the form.
3. In Section 3, as the patient, fill out your personal information accurately, including your name, date of birth, and contact details.
4. Proceed to Section 4 to provide financial information. Indicate if you have private insurance and state your yearly gross household income. Remember to attach a copy of your Notice of Assessment from Revenue Canada.
5. Finally, in Section 5, read and sign the consent form. If applicable, ensure that a parent or legal guardian signs on behalf of a minor.
6. Once completed, review the checklist provided at the bottom of the application to ensure all required fields are filled out correctly before mailing it to the specified address.

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