Medical Intake Form

1. Fill Out the Questionnaire: Provide accurate details about your medical history, medications and any allergies you may have. This information helps our physicians recommend the most suitable Box of Drugs for you.
2. Physician Review: A board-certified emergency medicine physician will review your submission within one business day and provide personalized recommendations.
3. Receive Your Recommendation: Once reviewed, you will receive an email with your recommended Box of Drugs and a link to purchase it for immediate delivery.

⚠️ Important: Do not purchase any medication box until your intake form has been reviewed by a physician. This ensures that your selection is safe and appropriate for your needs.