CAN Community Health:
AIDS Drug Assistance Program Inquiry Form 

Please complete below ADAP Program Inquiry Form. Our team will help you navigate the best coverage options and ensure you continue receiving your medications without interruption. Due to high volume, the CAN team will ensure to reach out to all inquiries within 1-7 business days.

When you submit this form, it will not automatically collect your details like name and email address unless you provide it yourself.