Resources & Tools

Document Checklist

Please use the following checklist to make sure you have done everything to complete the application process:

All fields of the application are completed or N/A is indicated
Healthcare provider has signed page 3 of application
Patient has signed page 4 of application
Product(s) are selected on page 2 of application
Most recent federal tax return is attached or box indicating patient does not file taxes is checked on application
Copy of application is retained for your records