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FILL OUT THE FORM BELOW FOR YOUR S.N.A.P.  or OTC Medicare Advantage Benefits Order

If there are any additional questions about how to access these benefits please reach out to theproducepac@gmail.com

Large PAC - 38.00

https://docs.google.com/forms/d/1SjFFtKv5Ewp7-D4QW2wi4tfUo4JFrqf9ngFYitUlKew/edit

PAC Grande  - Version en Espanol

https://docs.google.com/forms/d/1bJqYSB5dhr7sFX3F7j-mQ_fZPOTHWA2rEOmkpgUiC24/edit

Small PAC - 28.00

https://docs.google.com/forms/d/1-2QQ0V6oQRVRT6aDDKPKBUER33rocUKFhXE_ArMB2CU/edit

PAC pequeno- version en español 

https://docs.google.com/forms/d/1xV9Ob5puXXbTpXFxCxYoSoWBrlx66SBuTIzjf8Q_0ec/edit

Mini PAC - $18.00

https://docs.google.com/forms/d/14sGZfiZ_r-IBkR2ALb-N1GP0bPHkxJ7YCIrm0nhWriw/edit
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