Pre-appointment checklist

NJ drivers license/state ID

Current NJ drivers license or non driver ID

Referral Letter

This is a letter written by your managing provider or primary care physician stating the qualifying condition

Proof of address

Must be a utility Bill

2x2 passport style photo

Can be done with “passport photo” app or at local pharmacy chain

Click below to fill out our hipaa compliant patient form and telehealth consent

The physician will contact you for an introduction and review of medical records. A telehealth call will be scheduled at this time. (optional) Request a a free phone consultation or a text with program information prior to submitting