Call us toll free if you have any questions or to receive an application:
1-877-296-HOPE (4673)
Or use the form below to request an application to be sent to you.
You can also print an application and send to our mailing address:
Prescription Hope
P.O. Box 340856
Columbus, Ohio 43234-0856
Or Fax the application to us at: 1-877-298-1012
Contact Form
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