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Patient Assistance Programs for Healthcare Providers - Account Setup
Healthcare providers(HCP) and their staff can set up accounts online to order free medications for their patients through our automated patient assistance online system. We make it easy and fast to apply for patient assistance programs...

If you would like to create a FREE account for ONE HEALTHCARE PROVIDER, please read the instructions below.

In order to set up your free account and place orders online, the following criteria is required:

1 - You must be a healthcare provider or their staff

2 - A valid state license number for the healthcare provider

3 - An email address (this will become your login)
     Don't have an email address? Get a free email address from one of these providers: Gmail   Yahoo   Hotmail

4 - The medication for which the patient is applying

5 - The Patient's first and last name

Once you have the above information available, click on the button below and follow the instructions. You will be setting up your free account and creating an order for your patient all at the same time.

Setup Account