I Don't Have Insurance

This section provides information about the GSK Patient Assistance Program for patients who do not have insurance. This program does not constitute health insurance.

As of September 1, 2021 SORIATANE will no longer be available on the GSK Patient Assistance Program.

*The last date to submit a new or renewal application for these products is August 1, 2021.

*The last date to submit a refill request for SORIATANE is August 18, 2021.

As of October 1, 2021, COREG CR, JALYN, and RYTHMOL SR will no longer be available on the GSK Patient Assistance Program.

*The last date to submit a new or renewal application for these products is September 17, 2021.

*The last date to submit a refill request for these products is September 17, 2021.

Forms

Updated Application Forms Now Available

  • You may call 1‑866‑728‑4368 to request an application by mail, or download a program application here: