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. You must upload YOUR OWN Driver’s License/ID, the Driver’s License/ID of the patient (if patient is 18 years of age or older), AND official documentation of your authority to make healthcare decisions for the patient. NOTE: A financial power of attorney is not acceptable. If you cannot provide ALL required 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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