Request A Card

We would be happy to send you our free prescription drug discount card(s) in the mail, just complete the below request form.

Your cards will be mailed within one business day.

VERY Important: If you don't send a complete mailing address, we will NOT send you discount cards (street address, city, state and zip code)

Fields marked with * are required

Only Required if ordering 20 cards or more.
Only Required if ordering 20 cards or more.
INCLUDE: Street Address, City, State and ZIP code - (apartment # if applicable)

If  you’re business or organization needs a counter top display, we will send one free of charge.

(phone verification required)