Bristol+Myers+Squibb


 * Bristol Myers Squibb **[|www.bmscanada.ca]

Contact Patient Assistance Foundation : 1-800-267-1088 x 2514 Completed form **//and prescription//** for a maximum of 3 month course of the Bristol-Myers Squibb brand product being requested is then faxed to: 1-888-267-6211 A separate application 3 weeks prior to the patient requiring further medication must be submitted by the practitioner **__even to receive a refill of a medication previously received.__**

Eligibility:


 * patient must be a Canadian resident
 * patient cannot have or qualify for any private or government prescription coverage for the prescribed product
 * program is limited to certain products and may be or revised at any time at the sole discretion of Bristol-Myers-Squibb


 *  the patient monthly household income must be within the Patient Assistance Program eligibility level. This level is established at the sole discretion of Bristol –Myers-Squibb based on Statistics Canada Low Income Cut-Offs and will take into account the following criteria: the monthly income of the household and the number of dependents.

2. Orencia® Response Program
F**or more information, call the** **Orencia Response Program at: 1-877-979-3200  (toll-free). **