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Please Mail To: FutureScripts Dept. ×609 PO Box 419019 Kansas City, MO 64141 Future Scripts Prescription Reimbursement Claim Form (see reverse side for instructions) PART 1: CARDHOLDER/PATIENT INFORMATION

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How to fill out please mail to

1. Gather all the necessary information and documents required to fill out the mail.
2. Start by writing the date on the top right corner of the mail.
3. On the left side of the mail, write your name, address, and contact information.
4. Leave a space and write the recipient's name, address, and contact information on the left side of the mail.
5. Add a salutation or greeting below the recipient's information.
6. Compose your message or letter in a clear and concise manner, addressing the purpose or topic you are writing about.
7. Make sure to include any supporting documents or attachments if required.
8. Once the message is complete, close the mail with a polite closing phrase like 'Sincerely' or 'Best regards'.
9. Sign your name below the closing phrase if necessary.
10. Double-check for any spelling or grammatical errors before sealing the mail.
11. Place the mail in an envelope, seal it, and affix the necessary postage.
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Please mail to is a mailing address where certain documents or forms need to be sent.

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