Healthier Thickening

Helping Families in Need

Our patient assistance program provides deep discounts on Gelmix and Purathick for low income families that are denied coverage by insurance. Medicaid patients automatically qualify when thickening is deemed medically necessary.

Apply for the Parapharma Tech
WeCare Program Below

To apply for the discount program, please fill out the contact form below, upload a referral from your healthcare professional and provide proof of Medicaid.

All Fields Required

Patient First & Last Name *

Patient Birth Date *

Parent/Guardian First & Last Name *

Parent/Guardian Email Address *

Mailing Address *

City *

State *

Zip Code *

Phone Number *

Referring Healthcare Professional *

Medical Referral Form *

Upload medical referral form now OR
My healthcare provider will fax it to 866-950-7278

Upload Proof of Medicaid *

Which product are you requesting? *

Gelmix
Purathick

If this application is being completed by anyone other than the parent/guardian, please use the parent/guardian email address. The WeCare program requires a unique and valid email address to enroll in the discount program and to receive important program details. DO NOT USE HEALTHCARE PROVIDER EMAIL.

Once we receive the completed application and required documentation, we will email you with further program details by the next business day.

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