Open Door MedBank is designed for individuals (adults and children) who are uninsured and in need of prescription medications for a chronic illness that are out of reach financially.

For Self-Referrals, complete the form below, and let’s see how we can help.

Self-Referral Form:If you are uninsured and cannot afford your prescription medication, we may be able to help you obtain your medications for free or at a reduced price.

Complete the self-referral form and submit. An Open Door Medbank representative will follow up with you in the application process.

Providers, complete the form below, and let’s see how we can help.

Provider Referral Form: If you are a physician, nurse, social worker, case manager, or other healthcare professional, you can refer eligible patients to Open Door Medbank for assistance with obtaining free or low-cost prescription medications.

To refer a patient:
Please complete our Provider Referral Form or contact us directly by email, fax, or phone. An Open Door Medbank representative will follow up with the patient to assess eligibility and begin the application process.

If you have any questions or need additional information about our services, please don’t hesitate to connect with us. Phone: 706.323.1096, fax: 706-653-7160 or email: OpenDoorMedbank@odch.org.