Patient Advocate Foundation Financial Aid Fund Program Disclaimer

Patient Advocate Foundation’s Financial Aid Fund Division may offer a variety of Financial Aid Fund options available at any given time, with a current listing that can be found at www.patientadvocate.org/financialaid or by calling 1-855- 824-7941.

Each of Patient Advocate Foundation’s (“PAF’s”) Financial Aid Funds provides a pre-defined amount of financial assistance to patients who have been diagnosed with one of the conditions outlined in each fund’s criteria and who meet all of the qualifying criteria. The qualifying criteria for each fund can be found at www.patientadvocate.org/financialaid or by calling 1-855-824-7941.

PAF will not consider the identity of any physician, provider, supplier of items or services, donor, drug therapy, services or supplies being utilized, or the referral source when assessing whether an applicant is qualified for financial assistance through any of the available Financial Aid Funds. Under no circumstances will PAF recommend or refer a patient to any donor, provider, supplier, or product.

Qualifying patients are provided a one-time grant of the specified amount disclosed for each fund at the time they are approved for assistance from the Financial Aid Fund. Financial assistance through the Financial Aid Fund is provided on a first come, first serve basis to the extent the Financial Aid Fund has capacity to provide assistance.

Assistance from the Financial Aid Fund is not dependent on the use of a particular drug, particular supplies, or particular provider or suppliers and patients are free to switch drug therapies, treating physicians, pharmacies, and suppliers at any time without affecting their continued eligibility for assistance.

Patient Advocate Foundation reserves the right to request additional information to verify compliance with program eligibility guidelines. Failure to provide requested information may result in the closure of the application for assistance. Additionally, if at any time it becomes evident that information has been provided under false pretense the eligibility process for assistance will be terminated.

Patients’ contact information may be used in the future to share printed and/or electronic communications from PAF. If the patient does not wish to receive print and/or electronic communications from PAF, he/she may contact the program at 1-855- 824-7941 and request to have his/her contact information removed from the mailing list.

Patients’ data may also be used in de-identified aggregated reports. This means that information and data patients provide to PAF may be combined with other patients’ data to prepare reports analyzing patient needs and the Financial Aid Fund. PAF will only use de-identified patient data, i.e., patient data where all identifying data terms like the patient’s name, identifying numbers, etc. have been removed.