Receive Your Free Prescription Drug Card by Mail

If you would like to receive a Hard UV Coated Prescription Drug Card in the mail, please provide your name, address, and email address so we can send it to you right away and email you to let you know it has been sent.

If you would like a quantity of cards to hand out to people you know who are struggling with the prescription drug costs, to your patients or customers or anyone in need, please mention a brief overview of who you'll give them to below and how many you would like.

You don't have to wait for your card to arrive in the mail to start saving! After you fill out this form, click the Print Free Card link to print an active card that you can take it to the pharmacy today and begin saving! It's active and ready to be used by you, your entire family and anyone you may know that doesn't have prescription drug coverage.

PLEASE NOTE: If you are requesting a number of cards for a physicians office, organization, association or any other group, please let us know that in Special Instructions field below. We'll contact you to see if you would like additional materials such as brochures that explain our free discount program.