Get Started >> Sponsor Agreement >>

Step 1: Program Registration

It takes just a minute to complete the Rx Savings Program Registration form.
Magically, this information is then used to create an online document that requires a signature. You will automatically be directed to a web page for e-signature. 
{Our partner, RxCut, relies on DocuSign to securely track and electronically sign their important documents.}
Registration Form

Upon completion, please return to this page and click "Begin Step 2" button below.

Step 2: Form W-9

Begin Step 2