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Continued Access Program

As some medications are difficult for the Dispensary of Hope to keep sustained and consistent supply of, our Central Distribution Center has established a Continued Access Program with several pharmaceutical companies who provide the drugs in bulk rather than as samples.

The cost to the Patient to participate in this part of the program is $30 annually. Check or Money Order made out to Dispensary of Hope must be provided at the time of the original application.

If the patient qualifies, up to a 90 day supply of medication specific for that patient will be shipped from the Central Distribution Center to the Saint Thomas Dispensary of Hope location for the patient to pick up. Medications are shipped weekly and are ready to be picked up on Wednesday afternoon. New prescriptions and refill requests must be received by the end of the business day on Monday for the medication to be shipped out.

Refills for these specific medications can be called into 1-888-428-HOPE (4673).

Patient Criteria for Continued Access Program

  1. PDF -- pdf_1.pngTotal household income at or below 200% of the Federal Poverty Level.
  2. Patient must be a Tennessee Resident.
  3. Patient must show proof of residency (utility bill, driver’s license, paycheck stub, ID card, etc) -- PLEASE NOTE THAT P.O. BOXES ARE NOT ACCEPTABLE ADDRESSES FOR THIS PROGRAM.
  4. $30 processing fee (check or money order only)
  5. Patient cannot have Medicare (Part A, B or D), TennCare, or commercial insurance.
  6. Patient must sign all required consent and authorizations allowing the release of necessary information.

Application Check List

  1. Patient Application-- completed onsite at the Saint Thomas Dispensary of Hope
  2. PDF -- pdf_1.pngProvider Referral Form -- generated onsite at the Saint Thomas Dispensary of Hope (your physician must complete this form and fax back to us)
  3. Prescription-- physician must write an original prescription exclusively for this program and for that specific drug.
  4. Proof of Income (must accompany application)-- may include Tax return, W-2 form, Paycheck stub, Food Stamp letter, Letter from employer showing compensation, or Letter of Financial Support

PDF -- pdf_1.pngClick Here for a list of Medications currently offered through the Continued Access Program.