Instruction Sheet for the Client

Download Registration Form

To better assist you, please bring the following:

  1. Recipe (s) from your doctor – a prescription for each medicine.
  2. Proof of income – medications are available based on the level of income and what medical insurance covers or does not cover. Each company is different. 
 Please provide the following:
  3. The most current tax report. If taxes have not been reported, bring some other evidence such as:
  4. Check stubs current (for a month).
  5. Copy of the bank’s report for direct deposit.

Any other form that can give information (W-2).

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