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(888) 242-7460

Urbanek Providers- Order Device

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    Urbanek Device and Protocol
    8119 Isabella Lane Suite 108,
    Brentwood, TN 37027
    (888) 242-7460

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    ALTERNATIVE UPLOAD SCAN

    If you are having an issue with uploading scans with form above you may upload your scans to our alternate secure upload.

    TO SEND SCANS ATTACHED TO PRESCRIPTION, SAVE YOUR SCAN AS AN STL FILE BY CLICKING ON THE GREEN BUTTON BELOW. **Make certain the scan is saved as patients first name and last initial, followed by the Providers last name. Example: (Jennifer D, Dr. Smith)

    ALTERNATIVE UPLOAD SCAN

    ALTERNATIVE PRESCRIPTION FORM

    If you are having an issue with submitting the form above, you can click below to be redirected to our alternative form

    ALTERNATIVE PRESCRIPTION FORM