Instructions for Submitting Requests


ATTENTION 3RD PARTIES: The Options below are for patients only. If you are NOT a patient, please click here.

Welcome! Please read below

What You Need to Get Started

  1. The patient's valid driver's license or other valid state-issued ID.
  2. If you have the legal right to make healthcare decisions for a patient (custodial parent, legal guardian, healthcare trustee/conservator, healthcare proxy, medical/healthcare power of attorney), you may place the request on behalf of the patient. NOTE: A financial power of attorney is not acceptable. You must upload YOUR OWN Driver’s License/ID AND the Driver’s License/ID of the patient AND your official documentation of your ability to make healthcare decisions for the patient. If you cannot provide ALL of these items, the patient must place his or her own request.
  3. A credit card to make payment

Please have these items handy before you start!


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