EZ-Prescribe Online Ordering - HIPAA compliant & Secure

 
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Welcome to Zynex. 

This form is for patients with Commercial insurance (HMO/PPO). This form is HIPAA compliant and secure.

We look forward to helping you reach you pain management goals. This form is intended for patients whose doctors have prescribed them with a Zynex electrotherapy device. Please take a few moments to complete so that we can get your device to you.

Please note: If you have Medicare or Medicaid, please call 800-495-6670 option 1, as we cannot process your order online.
If you are prescribed a Cervical Traction ComforTrac unit, please also call 800-495-6670 option 1, as we cannot process your order online.

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