Refer A Patient

Note: If you experience any issues using our Refer A Patient form (e.g., a zip code error), please notify us by sending an email to In that event, please refer your patients via the following alternative methods:

  • For Exposure Counseling: please call 866-626-6847 (toll-free)
  • For Study Participation (with or without Exposure Counseling): please call 877-311-8972 (toll-free)