SAP Registration

To register to receive product through the SAP, please complete the secure form  providing information to confirm Health Canada’s authorization of your physician’s request and to provide billing information.  Once the completed form has been submitted, your credit card will be charged, and product will be shipped.  Confirmation of shipping with tracking information will be emailed to you.  Please note product will not be shipped until all required information has been submitted.  An invoice confirming payment will be sent to you by email for your records.

If you need assistance with the form please Contact Us.

    Contact Information

    Billing Address

    Credit Card Information