Prescription Assistance

The Patient Assistance Program (PAP) provides people who have limited incomes with free or low cost prescription drugs from the drug manufacturer.

1. Complete the Authorization and Release Form and return it to your pharmacist.

1. After the drug authorization form is completed and submitted to your pharmacist, the drug manufacturer will be contacted by our PAP advocates so the patient can begin receiving his/her drugs for free.
2. Patients will be able to pick up their drugs from the pharmacy for the first two months. After that, they will begin to receive their drugs through the mail. View more information about the prescription mail order program.

• Frequently asked questions about mail order program | Spanish version

Apply