For Patients


Welcome to the Patient Advocate Foundation Co-Pay Relief Program’s
(CPR) secured, on-line Patient Center!


For your convenience the on-line CPR Patient Center is available 24 hours, and you may submit application for assistance through this secure website.  Once you have fully completed the application, including all required fields of data, you will be notified immediately if you are eligible for assistance from CPR.  If you are eligible for assistance, the application will be instantly approved and you will have immediate program access.  This application process should take approximately 7-10 minutes to complete.  

To insure the continued integrity of the program, all patients approved for assistance are required to have a physician verify his/her diagnosis by completing and signing a Physician Verification Form and submitting it to the CPR program within 30 days of the patient’s approval date.   Additionally, certain patients will be randomly selected to submit documentation to verify reported income. Patient applications that are selected to submit income documentation are notified of this requirement immediately upon approval of the application for assistance and will have 30 days from their approval date to submit their documentation.   

Using the Patient Portal:

If this is your first time visiting the Co-Pay Relief Patient Center and you would like to register, please click Register. Please note that your name, contact information, social security or Alien ID number, date of birth and valid email address are 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.

If you would like to begin the application process, please click Start.

Portal User System Requirements include:

Internet Explorer 8 or higher
Google Chrome 30.0.15 or higher
Firefox 4.0
Adobe Reader 9 or higher version
File size uploads are limited to 2MB


Please note: Cookies must be enabled. Cookies are usually already enabled, but refer to your browser's help documents for instructions on how to enable cookies if they are disabled. If cookies are not enabled, you won't be able to log in, and will see the log-in page repeatedly.
Older versions of these browsers, or browsers not listed here, may work, however, if you experience any problems, please use one of the browsers listed above. Each one is free, widely available, and often pre-installed on many computers.