Submitting a prescription to ARESTIN Rx Access is easy 

Step 1:
Start a prescription online,* by phone, or by fax.

Before beginning a submission, make sure you have your patient's insurance card ready.

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Log in to the ARESTIN Rx Access Portal to print a pre-filled Prescription Form.

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Call the dedicated service center: 1-855-684-7481, 8 am-8 pm ET, Monday-Friday and a pre-filled Prescription Form will be faxed to you.

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Print and fill out a Prescription Form.

Step 2:
Complete and sign the Prescription Form and fax the signed form to 1-855-630-9783.

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Don’t forget, the Prescription Form requires a dentist’s signature, and a patient’s signature.

*Login required. Visit to create an account for the ARESTIN Rx Access Online Portal.

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