A Healthy CollaborationSM

Order Printed Materials

Please use this form to order enrollment materials for the Community CCRxSM Medicare Part D health plans. If you have trouble with the form, please contact the pharmacy technical call center at (866) 684-5395 24 Hours a Day, 7 Days a Week.

Please note that some items have multiple versions, which vary by region. These items are shown under a heading for each state you choose below. Items which do not vary by region are included under the section called All Regions.

S5803_09P0008_v4 (09/2009) Last Updated: 09/09/2022

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