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Resources
Lilly Cares Foundation Patient Assistance Program application
Lilly Cares Foundation Patient Assistance Program brochure:
If you know someone who may benefit from the Lilly Cares Foundation Patient Assistance Program, this brochure provides our toll-free number and website information.
Prescription Fax Form templates or refills for a Lilly Cares product:
The healthcare provider may use these optional Prescription Fax form templates when prescribing Forteo®, Humatrope®, Taltz®, or when ordering refills for a Lilly Cares product.

Forteo Prescription Fax Form when ordering Forteo.
Humatrope Prescription Fax Form when ordering Humatrope.
Humulin R U-500 Prescription Fax Form when ordering Humulin R U-500.
Taltz Prescription Fax Form when ordering Taltz.
Lilly Cares Fax Refill Order Form when ordering refills (excluding Forteo, Humatrope, Taltz) for enrolled Lilly Cares Patients.