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How to Order by Fax or Mail

1. Fill out a patient questionnaire

Click here to download a patient questionnaire form.

Offline Order Step 1

You will need Adobe Reader to view and print these forms. If you do not have Adobe Reader you may download a copy here.


2. Send your form(s), prescription(s), and payment

Please fax or mail your completed form(s), prescription(s), and payment. If you wish to fax or email us your prescription(s), please also mail us your original prescription(s).

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