1-866-223-9675

1-866-223-9675

ENROLL IN THE MY PRESCRIPTION SAVINGS CARD PROGRAM

Complete the enrollment form, print out your card, and take your card to your participating pharmacy the next time you fill or refill a prescription. To start the enrollment process, complete the information requested below and click Continue.

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Name

(mm/dd/yyyy)

Address

Contact Information

(you@domain.com)
(you@domain.com)
(xxx-xxx-xxxx)