MassMedLine Patient Profile
We at MassMedLine would like to work on your behalf to help you understand your medicines and to help you if you are having difficulties paying for your prescriptions. There are many options that can be explored. To help us focus our efforts on your specific needs, please follow these three steps:
Step One
Download the MassMedLine Patient Profile
Step Two
Please print and complete the profile as well as read, sign and date the required disclosure form. (The MassMedLine Patient Authorization form is optional.)
Note: Once your questionnaire is complete, you should make a copy of it for future reference.
Step Three
Mail the entire Patient Profile to MassMedLine at:
MassMedLine
Massachusetts College of Pharmacy and Health Sciences
25 Foster Street
Worcester, MA 01608
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