Contact Us

If you have questions that are not answered on this website, or if you would like to request to be contacted by one of our representatives, please fill out the form below and press the 'Submit' button. Please also indicate the best time of day for us to reach you. Thank you.

* Required Fields

Patient Name *

Your Name (If not the patient)

Invoice Number *

Batch Number (If no batch number please put 0) *

* Please include either your phone number or email address so that we may contact you.

Phone Number

E-mail Address

Please type your questions or special request here:

* To ensure security, please check the box below next to the phrase "I'm not a robot" to verify that you are an actual human submitting this information.