Registration Step 1:
Fill out the following form
Please fill out all fields. Once complete you must print, fill out, and return the KY Meds Check Draft Authorization Form.
If you would prefer to download the application and fax/email, please click here to download.
Registration Step 2:
Download, print, fill out, and return the KY Meds ACH Form via email to firstname.lastname@example.org or fax to 877-683-2065