How To Apply
|Who May Qualify|
|Frequently Asked Questions|
Applying for PAN assistance is easy.
You can start the application process for yourself or on someone else's behalf one of two ways:
1. Call 1.866.316.PANF (7263) A dedicated PAN counselor will work with you directly to help you:
Complete a pre-screen online, print and fill out the PDF application provided after the pre-screen, and submit it by mail or fax.
All applications and accompanying materials can be submitted by:
Application materials are provided on a patient-by-patient basis. All patients and their physicians will be notified in writing of the eligibility determination upon receipt and review of your completed application.
To be eligible for assistance, you must be a U.S. resident and meet certain financial, insurance, and medical criteria established by the Foundation's board of directors.
All applications must be verified by patients and their physicians and be supported by appropriate documentation including income verification.
Temporary Approval Process