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Complete a few questions and your patient information to submit for provider review.

Medical Review

A licensed provider will review your submission and follow up with next steps.

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After you submit, your information is sent for licensed provider review. Review time varies. You’ll see the next step on-screen after submission.

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Medication subtotal: $0.00

Price + Doctors fee: $0.00

Total: $0.00

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Complete the form and enter payment details, then click below to submit. If treatment is not approved, medication charges are refundable while the consultation fee may still apply.