Do I Qualify?

• FENTORA
• GABITRIL
• NUVIGIL
• PROVIGIL
• TREANDA
• TRISENOX

You may qualify for the CephalonCares^® Foundation GABITRIL® Patient Assistance Program if you answer “YES” to the following questions:

1. You have been prescribed GABITRIL®.
2. You do not have prescription drug coverage.
3. Your yearly household income does not exceed the following:



Click here to download an application and instructions, or call 877-CEPH881 (877-237-4881) to receive an application by mail or fax. We are staffed to assist you Monday through Friday, from 9:00 am – 8:00 pm Eastern time. Applications must be completed and signed by the patient and the physician.