Physician Resources Request Form

Please fill in the required fields below and let us know what items you'd like us to send to you. Click on any image to see a larger view of that item. Please note that there is no charge for any of these materials. Thanks again for referring your patients to us! We truly hope these materials will assist you in helping your patients control their environments through trigger management and provide them relief as a result. 

If you would like to speak to us directly, simply call us toll-free at 888-498-7401. Our phones are staffed by well-trained Representatives to assist you Monday through Friday between the hours of 9:00 am and 5:30 pm Eastern Time. You may also fax us at 800-395-9303 or e-mail us at [email protected]. Orders may be placed by phone by calling 800-522-1448 or on this website any time - 24 hours a day, 7 days a week.

For details about our privacy policy,click here.

This service is only for doctors practicing in the United States.

Fill out my online form.