Use this form to make updates to your patient account:

Request Dosage Increases

Please submit your request before your billing date. Requests received on your billing date will take effect on the next billing cycle.

Change Your Shipping Address

Ensure you submit address changes before your billing date. Do not submit changes on the billing date.

Update Your Credit Card Information

Change Your Billing Date: Submit this request before your current billing date. If submitted on the billing date, the change will take effect in the next billing cycle.