EnroLL NOW. Name * First Name Last Name Phone * (###) ### #### Email * Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Membership Enrollment Fee. * 50.00 75.00 How did you hear about us? Rx Assist ADV LLC Physician's Office Web (google, Web search) Friend/Family Message Thank you for enrolling. We're excited to have you as part of our community. We will be reaching out to you shortly to complete the enrollment process. If you have any questions or need assistance, don't hesitate to reach out. We're here to help!