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To complete your order, you must submit a recent doctor examination, the results of a recent blood test, and payment.

If you are in need of a doctor to complete your physical exam and blood test, our office staff can help with a referral to a local physician. Contact us for more information

1:  Submit forms by Fax at 1-310-277-7120

2:  Submit forms by email at info@diennet.com

3:  Submit payment by phone at 1-800-272-3436

If forms are sent directly from your doctor, please make sure your full name and contact information are included on form.

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