Medication Assistance Program
Living with kidney disease can be difficult and the BKA understands that CKD patients need regular monitoring and long-term care. We know that the medication cost for this disease is considerably high. The BKA is committed to bringing some relief to patients in this regard through our medication assistance program. Please sign up for our 6 month pilot program by August 26, 2022 as we offer Nephro-Vite to CKD patients for FREE at participating pharmacies starting September 1, 2022.
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Email *
Last name *
First name *
Gender *
Marital status *
Date of birth *
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How long have you been on dialysis? *
Are you employed? *
Do you have medical insurance? *
Do you have any disabilities? *
Do you have dependents? *
Are you currently taking Nephro-Vite? *
Are you currently taking Alfacalcidol? *
Primary number *
Secondary number
Physician *
Which Center do you have your dialysis treatments? *
Pharmacy of choice *
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