Admera PGx Supplies Re-Order Form
THIS ORDER FORM CAN ONLY BE COMPLETED BY CERTIFIED REPRESENTATIVES AND CERTIFIED TRAINERS.

To order additional buccal swab collection supplies for each of your accounts, please complete the following online form in its entirety.

UPDATE:
A separate supply tracking report is no longer needed! For your convenience, we have enhanced the ordering process by combining the supplies tracking within this supplies re-order form. All representatives re-ordering supplies for existing accounts will only be required to provide the quantity last received and where distributed.

If you need assistance, please contact the PGx/Doctor Setup Department at doctorsetup@medxprime.com or call 877-251-3505 Ext. 2.

**PLEASE NOTE; Suplies are shipped via FedEx Ground**

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