For more information, or to apply for the program, please contact a case management agency in your area or call 800-472-2180.
A PDF version of the application is also available online.
When you fill out this application:
- Answer all questions to the best of your knowledge.
- Sign and date where indicated.
- Return this form to your case manager or to:
Ryan White Program Part B
North Dakota Department of Health
Division of Disease Control
2635 East Main Avenue
Bismarck, ND 58506-5520
State covers some form of HCV drug therapies as part of their approved drug formularies: Yes
To learn more about what HCV drug therapies are on the drug formulary, please visit tiicann.org/co-infection-watch.html (go to page #7).