Interested in going through insurance? We’ll send this packet to your physician (or you can bring it to them) to get the information required to file a pre-authorization request.
Prescription form for The Fischer Tap Water Iontophoresis Device, to be filled out by a licensed healthcare practitioner.
You can request a specific form from us! Just do us a favor and please fill out this form to the right. One of our Treatment Specialists will attempt to locate the form and email it over.