Antigen Reorder Form

NOTICE:  Due to many insurance regulations antigens are being mixed based on your current vials expiration date. They can be mixed no earlier than 7 days prior to the expiration date. Please continue to order your antigen refills 2 weeks before the expiration date on the bottle.  You will be notified when they are ready.

PLEASE LET US KNOW IF YOU HAVE ANY CHANGE IN YOUR INSURANCE INFORMATION.

By clicking “Submit” you are agreeing that you understand that these antigens are mixed specifically for you and that, once mixed, you are responsible for any costs not covered by your insurance.