Free Medication, Patient Assistance Programs & More

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*Complete the short registration form for Immediate, Free Access to the Complete Details of this Patient Assistance Program.


Register for FREE

Complete the short form below to INSTANTLY Receive Your FREE MEDICATION Information

*Important information regarding how you can take advantage of FREE MEDICATION PROGRAMS will be sent to this email address.

Program Name: 304

This program provides medications FREE for patients who cannot afford them, and meet
certain other guidelines.

Medications covered:
DHE 45 injection 1 mg (dihydroergotamine mesylate)
Diastat rectal gel 2.5 mg (diazepam)
Diastat rectal gel 10 mg (diazepam)
Diastat rectal gel 20 mg (diazepam)
Migranal nasal spray 4 mg (dihydroergotamine with caffeine)
Mysoline tablets 50 mg (primidone)
Mysoline tablets 250 mg (primidone)

* Do You Need Help with your Free Medication Application?
* Do you want to know if you qualify to receive your medications for FREE?

Click 'Continue' & Complete the Form to be contacted by a Professional, Patient Assistance Agent.