| Pharmaceutical Company | ECR Pharmaceuticals |
| Program Address | P. O. Box 71600 Richmond, VA 23255 |
| Toll Free Phone Number | 800-527-1955 |
| Alternate Phone Number | 804-527-1950 |
| Fax Number | 804-527-1959 |
| Guidelines and Notes | This is an informal program. |
| Initiating Enrollment | The doctor contacts the area representative (if there is one) or mails the prescription to the directly to the company. |
| Health Provider's Role | The doctor writes a letters on office letterhead stating the patient's need and lack of prescription coverage and attaches a prescription. If there is a company representative in the area, the doctor may just explain the situation to him/her. |
| Patient's Role | Inform the physician that he/she can't afford the medicine. |
| How Dispensed | Sent to the doctor's office |
| Amount Dispensed | On a case-by-case basis and is up to the physician's discretion. |
| Estimated Response Time | Not specified |
| Refills | The same as the initial request |
| Limit | Unspecified |