Congratulations.

You've taken that first step. Here's the next.

ED TreatmentPatient Questionnaire

We need you to fill out this intake form for our doctors to review. Afterward, you’ll receive updates via email about your prescription. You may be contacted for further information, or if a virtual visit is required (this can vary by state).

Note: This step must be taken to complete your order. We have not charged your card yet, as you will only be charged after your prescription has been approved.