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Tax ID: 45-0510425

Patient
Data
Report
Request

Request a Copy of your Data Report
Optigen will request you mail us the data card from the back of your machine after you begin therapy. Upon receipt a report will be generated and made available to your physician. If you would like a copy of this report for your records please fill out the form below.
Please note: Unless requested by your physician, another data retrieval will not be required. If you feel that you need an additional data card, or have misplaced the original, please contact us at 1-800-273-9114 to have one sent to you.    

Request Data Report

First Name  *
Last Name  *
Middle Initial
Last 4 Digits of SS#
Email  *
Date of Birth
Date Format: 12/12/1990
 
  Please enter in the number below: