With the Chemo Mouthpiece Patient Assistance Program,
qualifying patients may receive a kit at no cost.
Eligibility required. Call now to enroll (888) 499-2122.

Program Details
- The Chemo Mouthpiece® Patient Assistance Program provides devices at no cost to eligible patients.
- The program is completely free to enroll.
- An authorized healthcare provider must prescribe
the device on the patient’s behalf. - Approval depends on product availability and verification of eligibility.
- Devices may be free for the patient and healthcare provider.
- There is no purchase requirement.
- The product may not be resold or billed to insurance or any third party.
If you have already received a bill for your Chemo Mouthpiece Patient Kit, you may still be eligible for the Patient Assistance Program. Contact us at: PatientAssistance@chemomouthpiece.com.
Enroll Today:
For more information and to enroll, contact us:
Monday–Friday, 9 am–6 pm ET
Phone: (888) 499-2122
Email: PatientAssistance@chemomouthpiece.com

