= SLIT & SCIT Treatment =

Ordering Immuno-therapy treatment is as easy as 1, 2, 3

Step 1

Fill out a prescription template

SCIT Description

SLIT Description

 

Step 2

Fax the prescription template

For SCIT Treatments, fax the prescription to (800) 309-7905

For SLIT Treatments, fax the prescription to 

(877) 357-1570

 

Step 3

Pay for the prescription

you ordered

Note: Orders will be fulfilled upon confirmation of the faxed prescription.

Medical Questionnaire

Please fill out the following form to help us understand your physical condition.

Have you been hospitalized in the last 12 months?
Are you currently suffering from a medical condition, illness, or injury?

Thanks for submitting!