THERAPEUTIC PHLEBOTOMY PHYSICIAN REQUEST FORM

Please download our Therapeutic Phlebotomy Request Form.

The treating healthcare professional is to complete, sign, and send back via email, text or fax :

Email:  1.drawntoyou@gmail.com

Text: (805) 391-4756

Fax: (805) 755-4521

 Therapeautic Request Forms are to be completed, signed, and sent back no later than 48 hours prior to scheduled appointment. We cannot perform the procedure if we do not have the proper documentation and instructions.