Campral (acamprosate)

Program name: Forest Pharmaceuticals Patient Assistance Program

Program address: 13645 Shoreline Drive Earth City, MO 63045-1241

Phone number: 800-851-0758

Fax number: NA

Forms: forepa0075.pdf

Eligibility guidelines
and notes: The patient must have no prescription coverage for the requested medication and

Application process: Anyone requesting assistance can call to request a faxed application or download it from the website.

Application requirements: The doctor must fill out a section, sign the application and attach a prescription.

Program details: Up to a 90-day supply is sent to the doctor's office.

Last updated: 7/24/2008

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