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The Leukemia & Lymphoma Society fax number

(877) 267-2932

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Co-pay Assistance Program

Used for: Submitting an Expenditure (copay assistance claims) for the Co-Pay Assistance Program

Fax destination details

Department
Co-pay Assistance Program
Purpose
Submitting an Expenditure (copay assistance claims) for the Co-Pay Assistance Program
Form
Proof of Expenditure (POE) form — POE – Proof of Expenditure for Co-Pay Assistance Program
Address
P.O. Box 12268, Newport News, VA 23612
Voice phone
(877) 557-2672

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.

Submit eligible copay expenses using the POE form, include receipts, and fax to the provided number or upload via the online portal as instructed in the program materials.

Review official form instructions

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