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Co-Pay Relief 1-866-512-3861
Co-Pay Relief
421 Butler Farm Road, Hampton, VA 23666
Phone: 1-866-512-3861 Fax: 757-952-0119

Disease and Treatment Silos:

Online Services for Patients



The Co-Pay Relief Program currently offers assistance for 19 diseases and conditions. Once a patient is approved for the program they are granted an annual award up to a certain amount based on their diagnosis. Please review the chart here as it provides you with a breakdown of award amounts by disease categories. The program cannot provide support in excess of the amounts shown, so look over expenditure submissions carefully to ensure that they do not exceed the allowable award amounts. We hope that this information will be helpful and thank you for allowing our program to serve as a resource for your co-payment needs.

Welcome to the PAF Co-Pay Relief Program's secured, web application portal for patient enrollment. Please be advised that only one application per patient will be accepted. The patient portal application registration process requires that you register by providing basic demographic information including date of birth, address and social security or alien identification number. Also note that a valid e-mail address is required to complete the process. Should you wish to access this patient resource, please click on the link below. We look forward to serving as a resource for your pharmaceutical co-payment needs! Should you need personal assistance you may reach our call counselors by dialing 1-866-512-3861.

Patient Portal

The CPR Program currently provides direct financial support to insured patients, who are financially and medically qualified, for pharmaceutical treatments and/or prescription medication co-payments, co-insurance and deductibles relative to your diagnosis.

Additionally, our program provides assistance to patients on a first come first serve basis and processes applicants in the order in which their completed applications are received. Please understand that a thorough review of the completed application packet, in its entirety, is necessary before a final determination of acceptance for assistance can be made.

For your convenience the Patient Center is available 24 hours and you may submit your application through this secure web-site which will expedite program access.

If you would like to begin the application process, please click “Start the Application Process”. If this is your first time visiting the Co-Pay Relief Patient Center and you will need to register on the next page.

Tips to Enhance Your CPR Experience!

Start the Application Process

Please note A valid email address is required to complete the registration process. After registering, you will receive an email to confirm your registration and create your password. Your account will not be active until you have confirmed your registration and created your password. Once this is done, you can log in any time with your email address and password.