Thank you for submitting the Latisse Intake and Consent Form. Your Medical Intake Questionaire has been saved! You only need to complete this once and will not be required for refill orders for the coming year.
Next Steps:
- If you had previously submitted an order and needed to complete the Medical Intake and Consent Form, your order will now be shipped.
Proceed with Checkout:
- If you have not yet completed your order, you can now proceed with purchasing your Latisse kit. Please select either the Latisse 5ML or Latisse 3ML Kit from below.