Once you have checked your eligibility, please complete this application. Be sure to follow all of the instructions and call if there are any questions.
To be eligible for the program:
- Fully complete the application (do not leave any blanks)
- Attach the proof of income
- Attach the proof of residency
- Sign the Notice of Privacy Practices (NOPP)
If one of those is not complete, it will take longer before you can be approved for the Wyoming Medication Donation Program
***Note: It is NOT possible to complete the application online and email from this website. Printing the application and scanning it to email is possible, however the network may not be secure and this is not the preferred method. Faxing or mailing the physical application is the best method.***
Prescription Assistance Program
The Wyoming Medication Donation Program’s mission is to use donated medicine to fill prescriptions for those who cannot afford it. We want to utilize what drugs are still usable to reduce waste, but sometimes what is donated is not enough to help our patients with their prescriptions.
To help our patients as much as we can, we are offering a new in-house service; we will coordinate the application process for Prescription Assistance Programs (PAP’s) available from some drug manufacturers for specific items . PAP’s allow patients to receive their medication directly from the drug manufacturer at no cost for up to a year.
If a current patient of WMDP is eligible to receive one or more of their medications from PAP, we will reach out to the patient and initiate the process. We are providing this additional service exclusively to current patients of WMDP. For more information, contact the prescription assistance office at (307) 635-1410 or email us at wdh-PAPinfo@wyo.gov.
The Dispensing Sites listed below work with the WMDP to provide patients in those towns with local aid. Please contact the Dispensing Site closest to you to see how you can apply through them. If there is not a site near you, please contact us and we can mail the medications directly to your door.
- Health Care for the Homeless: (Ph) 307-235-6116
- University of Wyoming Family Practice Residency Program: (Ph) 307-234-6161
- Health Works Pharmacy: (Ph) 307-637-7000
- Cedar Mountain Center (West Park Hospital): (Ph) 307-578-2529
- Downtown Clinic: (Ph) 307-745-8445
- Sheridan Health Center: (Ph) 307-674-6995