The following are the steps for patients to be considered for enrollment in the CCMAP

1. Complete the enrollment form on this website, including the patient's name, address,
   phone number, date of birth, Social Security number, a list of medications needed and
   the name and address of the patient's doctor(s).
2. Print out the enrollment form and mail it to the Cumberland County Medication Access Program.
3. Upon receipt of the form, we will review the application and respond by phone or postcard.
   If you do not have a phone, please include the name and phone number of someone who
   can receive messages for you. We will respond as quickly as possible, but please allow
   at least 1-2 weeks.