How to Fill Out the Prescription Form


The Prescription Form is very easy to fill out.  Please click on the button below to start.  After you have finished filling out the form, please print and fax the form to (888) 538-7484.  It is not required that you give us a call to make your appointment and faxing the prescription form.  Once you have scheduled the appointment online, you will receive a confirmation email confirming the appointment and a reminder to fax over the precription.


Precription Form


Watch our video below on “Filling out the prescription form” if you need any additional help.