If you or someone you know is struggling to afford medication please contact your healthcare provider and ask them to send us a completed referral form along with your prescriptions. Once that is received our office will contact you.
Identification
- Photo ID
Proof of Residence
- A piece of mail that includes your current physical address in one of the following 14 counties: Boone, Bracken, Campbell, Carroll, Fleming, Gallatin, Grant, Harrison, Kenton, Lewis, Mason, Owen, Pendleton, or Robertson.
Proof of Household Income For Each Member of the Household
- Tax Returns
- Pay Stubs / Unemployment
- Social Security Award Letter
- Pension Statements
- Food Stamp Letter if Zero Income
Proof of Insurance Status
- Current Prescription Insurance Card
