Let’s start by learning some valuable information about JScreen

We do not recommend using Internet Explorer to complete this form. You can download Mozilla Firefox by clicking here.

Before proceeding, you may want to grab your insurance card and the contact information for your personal healthcare provider, if you have one.
Let’s get started!

It was hard, but we’ve distilled volumes of technical information into a brief 2 minute video that highlights what you really need to know. Click anywhere in the video window below to begin. Once the video completes the order form will automatically load.

(Click anywhere in the video window below to begin.)

If for any reason you have difficulty viewing the video or the form that should appear following the video’s completion, please contact us at
[email protected] and we will be happy to assist you through the ordering process.