A+ A A-

Offline Order Form


Please follow the steps below to place your order.

To Email or Fax Your Order:


1. Download and fill out our Printable Order Form and Patient Release.

2. Email your completed forms and attached prescription(s) to This email address is being protected from spambots. You need JavaScript enabled to view it.
    - or fax them to us at 1-866-795-9461.

3. Call us at 1-888-243-7675 to complete payment and confirm your order details.