Differin (adapalene)

Company: Galderma Laboratories

Program name: Galderma Laboratories Patient Assistance Program

Program address: 122 S. Michigan Ave. Suite 100 Chicago, IL 60603

Phone number: 866-730-5074

Fax number: 312-935-3599

Forms: galder0077.pdf

Eligibility guidelines
and notes: The patient cannot have prescription insurance, be ineligible for any federal or state programs and

Application process: Anyone can write the company to request an application.

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

Program details: The patient is sent a pharmacy card that is valid for one month.

Last updated: 7/14/2008

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