Pernix Patient Assistance Program

Apply by mail

Simply click here to download an application, which you can print, complete, and return to us at:

Pernix Therapeutics Patient Assistance Program
PO Box 32444
Charlotte, NC 28232

If would like assistance or have any questions, we are happy to walk you through the application. Call 1-800-340-3042 to speak to a Pernix Therapeutics Patient Assistance Specialist, Monday through Friday, 9:00 a.m. to 5:00 p.m.


Once You Are Enrolled

If you qualify, you will automatically be mailed your first 90-day supply. You will then be eligible to receive free covered medicine(s) for up to one year by calling to refill your prescription every 3 months. You must re-enroll each year to remain in the program.