We make it convenient to fax an E-Z Script order:

1) Download the appropriate EZ Script below for your patients needs.

2) FAX the forms to BMS Toll Free: 1-800-952-5352

3) Please print out an EZ script below and complete the required information:

• Date and Start Date and Length of Need
• Patient Name and Address Demographics
• Patient Date of Birth
• Patient Height & Weight
• Fill Out the Appropriate Order Information
• Include any insurance or testing information with your order form
• Physician Printed Name and Signature are also Required

Please review the E-Z Script form options and fill out the required information on the appropriate E-Z Script form as per this example.

Click on the appropriate E-Z Script below to download and print out: