Get the up-to-date otsuka patient assistance application form 2023 now

Get Form
Form preview image

Here's how it works

01. Edit your form online
01. Edit your otsuka patient assistance foundation enrollment form online
Type text, add images, blackout confidential details, add comments, highlights and more.
02. Sign it in a few clicks
02. Sign it in a few clicks
Draw your signature, type it, upload its image, or use your mobile device as a signature pad.
03. Share your form with others
03. Share your form with others
Send otsuka patient assistance form via email, link, or fax. You can also download it, export it or print it out.

The easiest way to edit Otsuka patient assistance application form in PDF format online

Form edit decoration
9.5
Ease of Setup
DocHub User Ratings on G2
9.0
Ease of Use
DocHub User Ratings on G2

Working on documents with our extensive and intuitive PDF editor is easy. Adhere to the instructions below to fill out Otsuka patient assistance application form online easily and quickly:

  1. Sign in to your account. Sign up with your credentials or create a free account to test the product before choosing the subscription.
  2. Import a form. Drag and drop the file from your device or add it from other services, like Google Drive, OneDrive, Dropbox, or an external link.
  3. Edit Otsuka patient assistance application form. Effortlessly add and underline text, insert images, checkmarks, and icons, drop new fillable fields, and rearrange or remove pages from your paperwork.
  4. Get the Otsuka patient assistance application form completed. Download your modified document, export it to the cloud, print it from the editor, or share it with other people using a Shareable link or as an email attachment.

Take advantage of DocHub, the most straightforward editor to rapidly manage your paperwork online!

be ready to get more

Complete this form in 5 minutes or less

Get form

Got questions?

We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.
Contact us
was first approved by the FDA to treat schizophrenia in 2002. Is there a generic version of ? Yes, the generic name for the medication is and is available for purchase in the United States.
Cost Comparison of Generic and Brand-Name PharmacyBrand Name Cost for 5mg, 30 tabletsGeneric Cost for 5mg, 30 tabletsWalgreens$610.23$244.28Wegmans$581.46$14.14Duane Reade$610.23$244.28Target$606.23$199.884 more rows 23 Aug 2022
MYCITE is only available through a specialty pharmacy. The specialty pharmacy will fill your prescription for the MYCITE Kit and ship it to your doctors office.
It is an antipsychotic agent. This medicine is available only with your doctors prescription. oral solution was withdrawn from the market on May 15, 2015 and this dose form is not marketed by any generic manufacturers.
The Otsuka Patient Assistance Foundation, Inc. (OPAF) is a nonprofit organization that provides eligible patients with prescribed Otsuka medication free of cost. For assistance, please contact a Dedicated Patient Case Coordinator at 1-855-727-6274.
be ready to get more

Complete this form in 5 minutes or less

Get form

People also ask

is distributed to low income patients who meet certain eligibility criteria by the Bristol-Myers Squibb Patient Assistance Foundation, Inc. through the generous support of the Bristol-Myers Squibb Company and Otsuka America Pharmaceutical, Inc. Enclosed you will find the application form you had requested.

otsuka patient assistance foundation application