Nationwide Prescription Assistance

Free Medicine

DOWNLOAD PRINTABLE APPLICATION HERE

We're working to make it easier to access the many programs and informational resources available through Free Medicine help. If you were unable to find what you were looking for on this site, or even if you just want to ask us a question, call us. We're here to help you. You can talk to a live friendly person by calling toll-free 1-888-812-5152 Monday through Friday, 7:00 am to 6:00 pm CST, excluding holidays. Please get in touch!

Complete the form below to request a free enrollment brochure mailed to you. It should arrive in your mailbox in 7-10 business days. Or click here to apply online.
Or you can reach us at our mailing address: P. O. Box 515, Doniphan, Mo. Postal Code 63935-0515.

Contact Us

We're interested in hearing from you!

Please provide us with the following....
Light Yellow Boxes are Required

Name: title/First/Last

Company Name:

Address #1:

Address #2:

City / State / Zip:

Phone Number / Ext.:

Fax Number:

E-mail Address:

I am ...:

Comments:

This form is for requesting brochures, ONLY.

To ask a question, enter a comment, complaint, compliment, etc
use the Contact Form.

To request brochure/applications please choose one of the following options:

Another program resource are Prescription Discount Cards. These free cards are for anyone without prescription coverage in the USA. Please choose how many you need using one of the following options. Remember these are free and can be shared with anyone to help save on prescription meds immediately at a local participating pharmacy:

For larger quantities of the brochure/application and brochure displays please call 1-573-996-3333.

Have you previously requested brochure/applications?

Yes No

How did you hear about Free Medicine Help?