Boehringer Ingelheim Cares Foundation, Inc. fax number

Fax destination details

Department

Patient Assistance Program (PAP)

Purpose

Submitting Boehringer Ingelheim Cares Foundation Patient Assistance Program (PAP) applications and supporting documents to obtain BI medicines (e.g., Jardiance, Invokana) for eligible uninsured/underinsured patients.

Form

PAP application — Boehringer Ingelheim Cares Foundation Patient Assistance Program Application

Address

BI Cares Foundation Patient Assistance Program, PO Box 5520, Louisville, KY 40255

Voice phone

1-800-556-8317

Website

Visit organization website

Before you send

• Confirm that this exact department handles your document or request.
• Check the organization website or call its main line for the current fax number.
• Include a cover sheet and any case, member, claim, or form reference required.
• Keep the delivery confirmation with your submission records.

Complete the prescriber and patient sections, obtain physician signature, and submit the paper application by fax or mail with required documents (prescription, proof of income/insurance).

Official form instructions are published as a downloadable file on the organization's website.