{"id":28364,"date":"2026-05-29T09:17:12","date_gmt":"2026-05-29T16:17:12","guid":{"rendered":"https:\/\/ameripharmaspecialty.com\/?page_id=28364"},"modified":"2026-05-29T09:17:14","modified_gmt":"2026-05-29T16:17:14","slug":"nuwiq-copay-assistance","status":"publish","type":"page","link":"https:\/\/ameripharmaspecialty.com\/zh\/nuwiq-copay-assistance\/","title":{"rendered":"Nuwiq \u5171\u4ed8\u989d\u63f4\u52a9"},"content":{"rendered":"<style>\n\t@media screen and (min-width: 1023px) {\n\t\t.copayHeroBanner-image {\n\t\t\tposition: absolute;\n\t\t\ttop: 0;\n\t\t\tleft: 0;\n\t\t\twidth: 100%;\n\t\t\theight: 100%;\n\t\t\tz-index: -1;\n\t\t}\n\n\t\t.copayHeroBanner-image img {\n\t\t\tobject-fit: cover;\n\t\t\theight: 100%;\n\t\t\twidth: 100%;\n\t\t}\n\t}\n<\/style>\n\n<div  id=\"copay-hero-banner-171d75f04aa8bbef09f3b64ba7561787\" style=\"\" class=\"copayHeroBanner\">\n\t<div class=\"container\">\n\t\t<div class=\"banner-wrap \">\n\t\t\t<div class=\"content\">\n\t\t\t\t<p id=\"breadcrumbs\"><span><span><a href=\"https:\/\/ameripharmaspecialty.com\/vi\/\">Home<\/a><\/span><\/span><\/p>\t\t\t\t<h2 class=\"title\">Get Financial Relief Now<\/h2>\n\t\t\t\t<p class=\"text\">Apply for Nuwiq Copay Assistance<\/p>\n\n\t\t\t\t<div class=\"list\">\n\t\t\t\t\t<ul>\n<li>Free service matches you with top copay assistance programs<\/li>\n<li>Specialists assist you throughout the application process<\/li>\n<li>Get automated updates on your funding status<\/li>\n<li>Over $55 million secured for our patients to date<\/li>\n<\/ul>\n\t\t\t\t<\/div>\n\n\t\t\t\t\n\t\t\t\t\t<div class=\"button-wrap\">\n\t\t\t\t\t\t<a class=\"button\" href=\"#form\" target=\"_self\">Talk To A Specialist<\/a>\n\t\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/div>\n\t<\/div>\n\t<picture class=\"copayHeroBanner-image\">\n\t\t\t\t<source media=\"(min-width:1023px)\" srcset=\"https:\/\/ameripharmaspecialty.com\/wp-content\/uploads\/2023\/12\/copay-banner-desktop-scaled.jpeg\">\n\t\t<img decoding=\"async\" src=\"https:\/\/ameripharmaspecialty.com\/wp-content\/uploads\/2023\/12\/copay-banner-mbile-no-gradient.jpeg\" alt=\"\">\n\t<\/picture>\n<\/div>\n\n\n<div  id=\"copay-how-it-works-4310b17404baa18bc7320c630776c231\" style=\"\" class=\"copayAssistanceWork\">\n\t<div class=\"container\">\n\t\t<div class=\"copayAssistanceWork-wrapper\">\n\t\t\t<div class=\"top-section\">\n\t\t\t\t<h2 class=\"title\">How Assistance Works<\/h2>\n\t\t\t\t<p class=\"subtext\">Streamlining our patient\u2019s specialty pharmacy experience with unmatched full-service convenience<\/p>\n\t\t\t<\/div>\n\t\t\t\t\t\t\t<ul class=\"bottom-section\">\n\t\t\t\t\t\t\t\t\t\t\t<li class=\"list-item\">\n\t\t\t\t\t\t\t<img loading=\"lazy\" decoding=\"async\" width=\"63\" height=\"55\" src=\"https:\/\/ameripharmaspecialty.com\/wp-content\/uploads\/2023\/12\/step1.png\" class=\"attachment-full size-full\" alt=\"Coverage Verification Code\" \/>\t\t\t\t\t\t\t<div class=\"content\">\n\t\t\t\t\t\t\t\t<h4 class=\"step-title\">1. Check Your Coverage\/Benefits Verification<\/h4>\n\t\t\t\t\t\t\t\t<p class=\"description\">Our team of expert billers finds the best avenues of coverage that minimize out-of-pocket costs.<\/p>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/li>\n\t\t\t\t\t\t\t\t\t\t\t<li class=\"list-item\">\n\t\t\t\t\t\t\t<img loading=\"lazy\" decoding=\"async\" width=\"63\" height=\"55\" src=\"https:\/\/ameripharmaspecialty.com\/wp-content\/uploads\/2023\/12\/step2.png\" class=\"attachment-full size-full\" alt=\"Transfer Prescription to AmeriPharma - Image\" \/>\t\t\t\t\t\t\t<div class=\"content\">\n\t\t\t\t\t\t\t\t<h4 class=\"step-title\">2. Transfer Prescription to AmeriPharma\u00ae<\/h4>\n\t\t\t\t\t\t\t\t<p class=\"description\">We process your prescription by working with your previous pharmacy or prescriber, making the transition quick and easy.<\/p>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/li>\n\t\t\t\t\t\t\t\t\t\t\t<li class=\"list-item\">\n\t\t\t\t\t\t\t<img loading=\"lazy\" decoding=\"async\" width=\"63\" height=\"55\" src=\"https:\/\/ameripharmaspecialty.com\/wp-content\/uploads\/2023\/12\/step3.png\" class=\"attachment-full size-full\" alt=\"Icon - Eligard copay assistance process\" \/>\t\t\t\t\t\t\t<div class=\"content\">\n\t\t\t\t\t\t\t\t<h4 class=\"step-title\">3. Prior Authorization<\/h4>\n\t\t\t\t\t\t\t\t<p class=\"description\">Our team of specialists obtains approval from your insurance companies within 24 to 72 hours.<\/p>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/li>\n\t\t\t\t\t\t\t\t\t\t\t<li class=\"list-item\">\n\t\t\t\t\t\t\t<img loading=\"lazy\" decoding=\"async\" width=\"63\" height=\"55\" src=\"https:\/\/ameripharmaspecialty.com\/wp-content\/uploads\/2023\/12\/step4.png\" class=\"attachment-full size-full\" alt=\"Eligard Copay Financial Assistance Icon\" \/>\t\t\t\t\t\t\t<div class=\"content\">\n\t\t\t\t\t\t\t\t<h4 class=\"step-title\">4. Copay Assistance &#038; Financial Aid<\/h4>\n\t\t\t\t\t\t\t\t<p class=\"description\">We secure financial aid and decrease copays, out-of-pocket expenses, and high deductibles. To date, AmeriPharma\u00ae Specialty Care has secured $55 million in financial assistance for our patients.<\/p>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/li>\n\t\t\t\t\t\t\t\t\t\t\t<li class=\"list-item\">\n\t\t\t\t\t\t\t<img loading=\"lazy\" decoding=\"async\" width=\"63\" height=\"55\" src=\"https:\/\/ameripharmaspecialty.com\/wp-content\/uploads\/2023\/12\/step5.png\" class=\"attachment-full size-full\" alt=\"Nursing Care Logo\" \/>\t\t\t\t\t\t\t<div class=\"content\">\n\t\t\t\t\t\t\t\t<h4 class=\"step-title\">5. Nursing Care Coordination If Needed<\/h4>\n\t\t\t\t\t\t\t\t<p class=\"description\">AmeriPharma\u00ae puts your schedule and home environment first when scheduling and coordinating one of our specialized nurses for your in-home infusions.<\/p>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/li>\n\t\t\t\t\t\t\t\t\t\t\t<li class=\"list-item\">\n\t\t\t\t\t\t\t<img loading=\"lazy\" decoding=\"async\" width=\"63\" height=\"55\" src=\"https:\/\/ameripharmaspecialty.com\/wp-content\/uploads\/2023\/12\/step6.png\" class=\"attachment-full size-full\" alt=\"Delivery Coordination - Image\" \/>\t\t\t\t\t\t\t<div class=\"content\">\n\t\t\t\t\t\t\t\t<h4 class=\"step-title\">6. Delivery Coordination<\/h4>\n\t\t\t\t\t\t\t\t<p class=\"description\">Medications are always delivered in strict compliance with the specific requirements for shipping. Next-day and overnight cold-chain deliveries are coordinated around your schedule.<\/p>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/li>\n\t\t\t\t\t\t\t\t\t<\/ul>\n\t\t\t\t\t<\/div>\n\t<\/div>\n<\/div>\n\n\n<div  id=\"image-with-text-0045a564ae31288f4a6f644a8b698150\" style=\"\" class=\"small-photo ct_image_with_text\">\n        <div class=\"container\">\n        <div class=\"block-spacing block-wrap image_with_text \">\n                            <div class=\"image_with_text_content\">\n                    <h2 class=\"wp-block-heading\">What Is Nuwiq?<\/h2>\n<p>Nuwiq is a brand-name prescription medication.<\/p>\n<p>The active drug in this product is recombinant clotting factor VIII (rFVIII). rFVIII is also known as recombinant antihemophilic factor. It\u2019s in a class of medicines called\u00a0<a href=\"https:\/\/www.mayoclinic.org\/drugs-supplements\/antihemophilic-factor-intravenous-route\/description\/drg-20068497#:~:text=Antihemophilic%20factor%20(AHF)%20is%20a,does%20not%20make%20enough%20AHF.\">antihemophilic factors<\/a>. The term \u201crecombinant\u201d means Nuwiq is made in a lab using recombinant DNA technology.<\/p>\n<p>Little or no clotting factor VIII is present in the blood of people with hemophilia A. Because clotting factor VIII is essential for clot formation, its deficiency or absence can lead to potentially fatal spontaneous internal bleeding.<\/p>\n<p>Mild hemophilia A may cause trouble controlling bleeding following injury or surgery.<\/p>\n<p>The US FDA initially approved Nuwiq to treat and control bleeding episodes in children and adults with hemophilia A in 2015.<\/p>\n<p>This medication works by replacing factor VIII in people living with hemophilia A.<\/p>\n                <\/div>\n                                        <div class=\"image_with_text_media\">\n                    <picture>\n                                                <source loading=\"lazy\" media=\"(min-width:768px)\" srcset=\"https:\/\/ameripharmaspecialty.com\/wp-content\/uploads\/2024\/02\/pharmacist.jpg\">\n                        <img decoding=\"async\" loading=\"lazy\" src=\"https:\/\/ameripharmaspecialty.com\/wp-content\/uploads\/2024\/02\/block_image_mobile.jpg\" alt=\"https:\/\/ameripharmaspecialty.com\/wp-content\/uploads\/2024\/02\/pharmacist.jpg\" style=\"width:auto;\">\n                    <\/picture>\n                <\/div>\n                    <\/div>\n    <\/div>\n<\/div>\n\n\n<div  id=\"image-30-text-70-60a557f9620a783e623fe18e73fe5a4f\" style=\"\" class=\"img30text70 light_gray\">\n\t<div class=\"container\">\n\t\t<div class=\"block-wrap left\">\n\t\t\t<div class=\"block-column image\">\n\t\t\t\t<picture class=\"image-30\">\n\t\t\t\t\t\t\t\t\t\t<source loading=\"lazy\" media=\"(min-width:768px)\" srcset=\"https:\/\/ameripharmaspecialty.com\/wp-content\/uploads\/2024\/02\/block_image_1.jpg\">\n\t\t\t\t\t<img decoding=\"async\" loading=\"lazy\" src=\"https:\/\/ameripharmaspecialty.com\/wp-content\/uploads\/2024\/02\/block-image-2.jpeg\" alt=\"https:\/\/ameripharmaspecialty.com\/wp-content\/uploads\/2024\/02\/block_image_1.jpg\" style=\"width:auto;\">\n\t\t\t\t<\/picture>\n\t\t\t<\/div>\n\t\t\t<div class=\"block-column\">\n\t\t\t\t<div class=\"text\">\n\t\t\t\t\t<div class=\"wpb_text_column wpb_content_element\">\n<div class=\"wpb_wrapper\">\n<h2 class=\"wp-block-heading\">What Is Nuwiq Used To Treat?<\/h2>\n<p>The\u00a0<a href=\"https:\/\/www.fda.gov\/\">US FDA<\/a>\u00a0has approved Nuwiq for use in children and adults to:<\/p>\n<ul class=\"wp-block-list\">\n<li>Control and treat bleeding episodes.<\/li>\n<li>Prevent bleeding during surgery.<\/li>\n<li>Reduce the frequency of bleeding episodes.<\/li>\n<\/ul>\n<p>This product shouldn\u2019t be used to treat another type of bleeding disorder called\u00a0<a href=\"https:\/\/my.clevelandclinic.org\/health\/diseases\/17709-von-willebrand-disease\">von Willebrand disease<\/a>.<\/p>\n<h2 class=\"wp-block-heading\"><span id=\"What_Should_You_Know_Before_Using_Nuwiq\" class=\"ez-toc-section\"><\/span>What Should You Know Before Using Nuwiq?<\/h2>\n<p>Tell your provider if you have ever had inhibitors to factor VIII.<\/p>\n<\/div>\n<\/div>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/div>\n\t<\/div>\n<\/div>\n\n\n<div  id=\"copay-assistance-019e87721562e07204bc80a6b7432331\" style=\"\" class=\"copayAssistance\">\n\t<div class=\"container\">\n\t\t<div class=\"copayAssistanceWrap\">\n\t\t\t<h2 class=\"title\">Copay and Financial Assistance<\/h2>\n\t\t\t<p class=\"text\">AmeriPharma\u00ae Specialty Pharmacy alleviates financial burdens for patients and their families<\/p>\n\t\t\t\t\t\t\t<ul class=\"list\">\n\t\t\t\t\t\t\t\t\t\t\t<li class=\"list-item\">\n\t\t\t\t\t\t\t<div class=\"icon\">\n\t\t\t\t\t\t\t\t<img loading=\"lazy\" decoding=\"async\" width=\"75\" height=\"75\" src=\"https:\/\/ameripharmaspecialty.com\/wp-content\/uploads\/2023\/11\/icon1-1.png\" class=\"attachment-full size-full\" alt=\"Advanced software Icon\" \/>\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<p class=\"sub-text\">Advanced software locates funding sources to match you with top-dollar foundation programs<\/p>\n\t\t\t\t\t\t<\/li>\n\t\t\t\t\t\t\t\t\t\t\t<li class=\"list-item\">\n\t\t\t\t\t\t\t<div class=\"icon\">\n\t\t\t\t\t\t\t\t<img loading=\"lazy\" decoding=\"async\" width=\"67\" height=\"66\" src=\"https:\/\/ameripharmaspecialty.com\/wp-content\/uploads\/2023\/11\/icon2.png\" class=\"attachment-full size-full\" alt=\"Copay and Financial Assistance\" \/>\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<p class=\"sub-text\">One of our copay assistance specialists will assist with the application process<\/p>\n\t\t\t\t\t\t<\/li>\n\t\t\t\t\t\t\t\t\t\t\t<li class=\"list-item\">\n\t\t\t\t\t\t\t<div class=\"icon\">\n\t\t\t\t\t\t\t\t<img loading=\"lazy\" decoding=\"async\" width=\"75\" height=\"75\" src=\"https:\/\/ameripharmaspecialty.com\/wp-content\/uploads\/2023\/11\/icon3.png\" class=\"attachment-full size-full\" alt=\"Funding Icon\" \/>\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<p class=\"sub-text\">Automatic updates will be sent to you and your physician on the status of the funding<\/p>\n\t\t\t\t\t\t<\/li>\n\t\t\t\t\t\t\t\t\t<\/ul>\n\t\t\t\t\t<\/div>\n\t<\/div>\n<\/div>\n\n\n\n<div  id=\"image-30-text-70-8382ac7f75c632b2000b79bc76c86ea4\" style=\"\" class=\"img30text70 white\">\n\t<div class=\"container\">\n\t\t<div class=\"block-wrap right\">\n\t\t\t<div class=\"block-column image\">\n\t\t\t\t<picture class=\"image-30\">\n\t\t\t\t\t\t\t\t\t\t<source loading=\"lazy\" media=\"(min-width:768px)\" srcset=\"https:\/\/ameripharmaspecialty.com\/wp-content\/uploads\/2024\/02\/Mask-Group-45-1.jpg\">\n\t\t\t\t\t<img decoding=\"async\" loading=\"lazy\" src=\"https:\/\/ameripharmaspecialty.com\/wp-content\/uploads\/2024\/02\/Mask-Group-45-2.jpg\" alt=\"https:\/\/ameripharmaspecialty.com\/wp-content\/uploads\/2024\/02\/Mask-Group-45-1.jpg\" style=\"width:auto;\">\n\t\t\t\t<\/picture>\n\t\t\t<\/div>\n\t\t\t<div class=\"block-column\">\n\t\t\t\t<div class=\"text\">\n\t\t\t\t\t<div class=\"wpb_text_column wpb_content_element\">\n<div class=\"wpb_wrapper\">\n<h2 class=\"wp-block-heading\">How Is Nuwiq Supplied and Used?<\/h2>\n<p>This medicine comes as a white, sterile powder for intravenous infusion in single-use vials. The following strengths (measured in international units\/IU) are available in the US:<\/p>\n<ul class=\"wp-block-list\">\n<li>250 IU<\/li>\n<li>500 IU<\/li>\n<li>1,000 IU<\/li>\n<li>1,500 IU<\/li>\n<li>2,000 IU<\/li>\n<li>2,500 IU<\/li>\n<li>3,000 IU<\/li>\n<li>4,000 IU<\/li>\n<\/ul>\n<p>One IU, in this medication, measures the amount of clotting factor VIII that is approximately equal to the level of factor VIII activity in 1 ml of human plasma.<\/p>\n<h3 class=\"wp-block-heading\"><span id=\"Proper_Use\" class=\"ez-toc-section\"><\/span>Proper Use<\/h3>\n<p>Your provider will perform a blood test to determine if this medication best suits your needs.<\/p>\n<p>Before giving you Nuwiq as an infusion into your vein, your provider will calculate the dose using specific formulas. Then, they will prepare the solution for intravenous injection following instructions on the package.<\/p>\n<p>Factors that determine the dose and duration of treatment include:<\/p>\n<ul class=\"wp-block-list\">\n<li>Severity of factor VIII deficiency<\/li>\n<li>Location and severity of bleeding<\/li>\n<li>Your body weight and overall health<\/li>\n<li>Desired factor VIII level<\/li>\n<li>Condition being treated<\/li>\n<\/ul>\n<\/div>\n<\/div>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t<\/div>\n\t<\/div>\n<\/div>\n\n\n<div  id=\"copay-side-effect-list-4efb70ab37e702b267958cc34a35dffc\" style=\"\" class=\"copaySideEffectList\">\n\t<div class=\"container\">\n\t\t<h2 class=\"title\">Nuwiq Side Effects<\/h2>\n\t\t<div class=\"content  sideEffectList\" id=\"sideEffectList\">\n\t\t\t<h5><strong>Common side effects include:<\/strong><\/h5>\n<ul class=\"wp-block-list\">\n<li>Upper or lower respiratory tract infection<\/li>\n<li>Headache<\/li>\n<li>Fever<\/li>\n<li>Cough<\/li>\n<li>Inflammation in the nose or throat<\/li>\n<li>Chills<\/li>\n<li>Abdominal pain<\/li>\n<li>Joint pain<\/li>\n<li>Anemia<\/li>\n<li>Pain, swelling, itching, or redness at the injection site<\/li>\n<\/ul>\n<div class=\"wpb_text_column wpb_content_element\">\n<div class=\"wpb_wrapper\">\n<h5><\/h5>\n<h5><strong>Serious side effects include:<\/strong><\/h5>\n<\/div>\n<\/div>\n<div class=\"wpb_text_column wpb_content_element\">\n<div class=\"wpb_wrapper\">\n<ul class=\"wp-block-list\">\n<li>Increased bleeding episodes<\/li>\n<li>Any bleeding that will not stop<\/li>\n<li>Chest pain<\/li>\n<li>A feeling like you might faint<\/li>\n<\/ul>\n<\/div>\n<\/div>\n\t\t<\/div>\n\t<\/div>\n<\/div>\n\n\n<div  id=\"copay-insurance-companies-ffaf59be85285ef3e7be7b75a209417d\" style=\"\" class=\"copayInsuranceCompanies\">\n\t<div class=\"container\">\n\t\t<h3 class=\"title\">Insurances Accepted<\/h3>\n\t\t<p class=\"text\">We accept Medicare, multi-state Medicaid, Medi-Cal, Blue Shield, and most private insurances. Call us to find out more about your coverage.<\/p>\n\t\t\t\t\t<ul class=\"list\">\n\t\t\t\t\t\t\t\t\t<li class=\"list-item\">\n\t\t\t\t\t\t<img loading=\"lazy\" decoding=\"async\" width=\"218\" height=\"34\" src=\"https:\/\/ameripharmaspecialty.com\/wp-content\/uploads\/2024\/01\/medicare-footer-logo.png\" class=\"attachment-full size-full\" alt=\"Medicare logo displayed in the website footer.\" srcset=\"https:\/\/ameripharmaspecialty.com\/wp-content\/uploads\/2024\/01\/medicare-footer-logo.png 218w, https:\/\/ameripharmaspecialty.com\/wp-content\/uploads\/2024\/01\/medicare-footer-logo-86x13.png 86w, https:\/\/ameripharmaspecialty.com\/wp-content\/uploads\/2024\/01\/medicare-footer-logo-167x26.png 167w\" sizes=\"auto, (max-width: 218px) 100vw, 218px\" \/>\t\t\t\t\t<\/li>\n\t\t\t\t\t\t\t\t\t<li class=\"list-item\">\n\t\t\t\t\t\t<img loading=\"lazy\" decoding=\"async\" width=\"270\" height=\"58\" src=\"https:\/\/ameripharmaspecialty.com\/wp-content\/uploads\/2024\/07\/medicaid-gov-logo.png\" class=\"attachment-full size-full\" alt=\"Medicaid logo\" srcset=\"https:\/\/ameripharmaspecialty.com\/wp-content\/uploads\/2024\/07\/medicaid-gov-logo.png 270w, https:\/\/ameripharmaspecialty.com\/wp-content\/uploads\/2024\/07\/medicaid-gov-logo-86x18.png 86w, https:\/\/ameripharmaspecialty.com\/wp-content\/uploads\/2024\/07\/medicaid-gov-logo-167x36.png 167w\" sizes=\"auto, (max-width: 270px) 100vw, 270px\" \/>\t\t\t\t\t<\/li>\n\t\t\t\t\t\t\t\t\t<li class=\"list-item\">\n\t\t\t\t\t\t<img loading=\"lazy\" decoding=\"async\" width=\"200\" height=\"104\" src=\"https:\/\/ameripharmaspecialty.com\/wp-content\/uploads\/2023\/11\/Image-137.png\" class=\"attachment-full size-full\" alt=\"Blue Cross Blue Shield Logo\" srcset=\"https:\/\/ameripharmaspecialty.com\/wp-content\/uploads\/2023\/11\/Image-137.png 200w, https:\/\/ameripharmaspecialty.com\/wp-content\/uploads\/2023\/11\/Image-137-86x45.png 86w, https:\/\/ameripharmaspecialty.com\/wp-content\/uploads\/2023\/11\/Image-137-167x87.png 167w\" sizes=\"auto, (max-width: 200px) 100vw, 200px\" \/>\t\t\t\t\t<\/li>\n\t\t\t\t\t\t\t<\/ul>\n\t\t\t<\/div>\n<\/div>\n\n\n\n<div id=\"form\">\n\t<div  id=\"copay-form-d01a1c8b14eda0d99d51018b0d7d7bdf\" style=\"\" class=\"copayForm\">\n\t\t<div class=\"container\">\n\t\t\t<div class=\"copayForm-wrapper\">\n\t\t\t\t<div class=\"content\">\n\n\t\t\t\t\t\t\t\t\t\t\t<h2 class=\"title\">Get Started in Minutes<\/h2>\n\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t<p class=\"text\">Fill out your information and one of our specialists will call you ASAP.<\/p>\n\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t<h3 class=\"question\">How Much Can You Save?<\/h3>\n\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t<p class=\"answer\">Complete this form to save up to 100%!<\/p>\n\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t<!--<a class=\"contact-button\" href=\"tel:8777780318\">(877) 778-0318<\/a>-->\n\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<div class=\"form\">\n\t\t\t\t\t<div id=\"iframe-container\"><\/div>\n\t\t\t\t\t<script>     \n                        window.addEventListener('DOMContentLoaded', () => {\n                            function buildForm(posthogID) {\n                                let formId = 'Lac86iCjiIyfdFLJylVF';\n                                let formHeight = '400px';\n                                function getURLParameter(e){return decodeURIComponent((RegExp(e+\"=(.+?)(&|$)\").exec(location.search)||[,null])[1])}   \n                                let utmParams = ['utm_source','utm_medium','utm_campaign','utm_campaignid','utm_adgroup','utm_term','utm_keyword','keyword','device','match','loc','utm_network','gclid','extensionid', 'sitelink']; 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