Full Name
Email
Phone
'Thank you for completing the questionnaire.
The next step will direct you to one of our licensed patient care professionals to assist you in determining if the PearlPAK treatment is a good fit for you.

At this stage, your credit card number is collected but NO FEES ARE CHARGED until AFTER to appointment with the physician. The physician visit fee is $49 and will be process ONLY AFTER your visit. If you have added a promo code there will be no physician fee after you visit.

If you and the physician decide to move forward with a prescription, a separate transaction will be processed for the prescription for $97. Please also reference your email for additional information.