New Client

Interested in using our lab? To receive a comprehensive packet detailing all our products and services, please fill out the below form or call us at 800.647.8748

Name *
Name
Address *
Address
Phone *
Phone
Would you like a Laboratory Representative to contact you to discuss a treatment plan? *

Click below for a printable Prescription!

Current Client

Request a pick-up, more RX pads, shipping labels, or boxes.

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Name
Address *
Address
Phone *
Phone
I would like to request... *
Please write any other requests in this box.