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The membership application is now available online with easy-to-follow instructions
and tools to help you complete it. There is no obligation for submitting your application.
Begin Online Application for Free Prescription Medications »
To apply by phone you may call us now at (877)331-0362
or contact customer service and we will contact you at our earliest convenience.
For prompt service, be sure to have your medication list and most current income information available.
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