Glaucoma Patient Assistance Program (PAP)
Sponsor Organization
Alcon Labs
Prescription Medication Assistance Organization Contact
Glaucoma PAP
Humanitarian Services T7-18
6201 South Freeway
Ft. Worth, TX 76134
(800) 222-8103 Option 1
Medications sent to: Patient’s Doctor
Prescription Medications/Products Covered:
Azopt
Betoptic S
Carteolol HCl
Dipivefrin
Iopidine
IsoptoCarbachol
IsoptoCarpine
Levobunolol HCl
Metipranolol Solution
Pilopine HS
Timolol Maleate
Travatan
Program Eligibility Requirements:
Patient cannot have a prescription reimbursement insurance, must be indigent and needy, and physician must be an optometrist or ophthalmologiSt
Additional Information and/or Requirements (known):
New Application Forms are required for refills.
Link: Prescription Medication Program Website
