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Take Your PASS to Great Savings and Less Worry . . . Enroll Today.

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Complete and Return Your Enrollment Form Today!

It can take several weeks to complete the process of submitting your medication application(s) for participation in the various Patient Assistance Programs, so we encourage you to complete your enrollment form and start the process as soon as possible. We look forward to helping you take advantage of the significant savings on your prescription medications available through Patient Assistance Programs.

Submit Your Enrollment Form with Confidence

PASS is committed to protecting your personal privacy. We will use the information you provide to PASS only to complete the individual medication applications as required by the pharmaceutical companies that supply the prescription medications you take. We will never disclose your personal information to any other person or entity.

Our Pledge to You as a PASS Client

PASS is dedicated to providing you, our valued client, with complete, worry-free assistance in applying for substantial savings on your prescription medications to help you enjoy a healthier lifestyle. Once you are enrolled, we work diligently on your behalf to reduce the burden of paying for costly prescription medications.