Patient Assistance Program Agreement Sample Contracts

BY AND AMONG
Patient Assistance Program Agreement • May 29th, 2003 • Medco Health Solutions Inc • Retail-drug stores and proprietary stores • New York
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This Agreement is between Avedro, Inc. (“Avedro”) and (“Practice”), collectively, the “Parties,” each at the office addresses
Patient Assistance Program Agreement • August 25th, 2020

provided below. In order to improve patient access to safe, high-quality, FDA-approved products and procedures, the Parties voluntarily agree to the following Avedro Patient Assistance Program (“PAP”) Terms and Conditions. This Agreement shall be deemed to extend to any healthcare providers that are associated with, or practice in connection with, the Practice (collectively, “Providers”) and Providers shall be bound by the terms hereof.

TERMS AND CONDITIONS OF PFIC PATIENT ASSISTANCE PROGRAM
Patient Assistance Program Agreement • September 2nd, 2024

Agreement. By submitting your application (the “Application”) for the PFIC Patient Assistance Program (the “Program”), you hereby agree to these Terms and Conditions, which shall become shall become a binding agreement (the “Agreement”) between you and Progressive Familial Intrahepatic Cholestasis Advocacy and Resource Network, Inc. (“PFIC”) as of the date that your application is submitted.

This Agreement is between Avedro, Inc. (“Avedro”) and (“Provider”), collectively, the “Parties,” each at the office addresses
Patient Assistance Program Agreement • March 2nd, 2020

provided below. In order to improve patient access to safe, high-quality, FDA-approved products and procedures, the Parties voluntarily agree to the following Avedro Patient Assistance Program (“PAP”) Terms and Conditions.

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