*Maximum amount is one per applicant in six month period
Eligibility for the Allergan Pharma, Inc. 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 product you require at no charge. Your medication will be shipped to your licensed practitioner's office for them to dispense to you.
Download Application Form
Frequently Asked Questions
Eligibility for the Allergan Pharma, Inc. 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 product you require at no charge. Your medication will be shipped to your licensed practitioner's office for them to dispense to you.
Please contact us for more information:
Phone: +1 844 4AGN PAP (+1 844 424 6727)
Fax: +1 844 708 0036
Phone: +1 844 4AGN PAP (+1 844 424 6727)
Fax: +1 844 708 0036