Welcome! To order samples of MOXATAG, you must be a licensed medical practitioner. To begin, please register for an on-line account. Once you’re finished registering, the ordering process is completed in three easy steps:

1. Choose the quantity of samples you would like to order.
2. Review your order.
3. Print your order and fax it to the number displayed on the Sample Request Form.

All approved orders will be processed within 3 business days, once license status has been verified.