For your convenience, links to intake and questionnaire forms are provided below. NOTE: Prior to returning any questionnaires, your child’s primary care physician must submit an intake form and an insurance referral, as some require a prior authorization.

Paying for Your Prescriptions

If you’re struggling with prescription affordability, we can recommend a variety of resources to help you remain on track with your medications and your overall health.

Talk to your doctor, clinical team, or pharmacist about:

• Prescription Assistance Programs
• Price Comparison Tools and Coupons
• Ways to Save Money on Medications

Prescription Affordability Resources

The Prescription Advantage Program 
MA Residents Patients 65 and older and those with disabilities
A state-sponsored prescription assistance program administered by the Executive Office of Elder Affairs.
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Sickle Cell Disease Treatment in Central Massachusetts and Beyond

Our Children’s Medical Center is home to the Pediatric Sickle Cell program, the only program of its kind in Central Massachusetts. Our close-knit team includes board-certified pediatric hematologist-oncologists, pediatric nurses, social workers and child life specialists. We give your child a level of care and attention that is hard to find at larger institutions.

As a member of the New England Pediatric Sickle Cell Consortium, we receive the latest sickle cell updates from institutions throughout the region. This collaboration...