All the forms below are in . pdf format and require Adobe Reader to view. If you do not have Adobe Reader, feel free to download a free version of Adober Reader...

Enrollment Application - English
Enrollment Application - Spanish

Requirements - English
Requirements - Spanish

Before submitting the applications:
* Make sure all questions have been answered or filled in.
* Attach proof of income (see Requirements)
* Attach a copy of your state I.D.
* Attach any benefit denial letters from any state or government agencies (if available)
* Enclose a check or money order in the amount of $50 addressed to: The Medicine Cabinet

*Note: The enrollment process will NOT start until the enrollment fees are received... see "Requirements" page for more information.

Forms can be mailed, faxed, or emailed to our office:

The Medicine Cabinet
1805 S. Eastern Ave.
Las Vegas, NV 89104

Fax: 702-650-2184
Email: cs@tmcmeds.com