Front of ID

sf-required

Manage recurring validation states.
sf-form_input
sf-required
Field Input (Required)
sf-form_checkbox-field
sf-required
Checkbox (Required)
sf-form_radio-field
sf-required
Radio (Required)
sf-form_input-select
sf-required
Select (Required)
sf-form_input-date
is-icon-left-right
sf-required
sf-form-icon-left
sf-required
Date Input (Required)
This is an error tag
sf-form_input-error-wrapper
sf-required
Error Tag (Required)
sf-form-icon-right
sf-required
Icon on Input Right (Required)
sf-form-icon-left
sf-required
Icon on Input Left (Required)
sf-form-icon-right
is-text-area
sf-required
Icon on Input Right Text Area (Required)

sf-checked

Manage recurring checked radio & checkboxes states.
sf-form_checkbox-field
sf-checked
Checkbox (Checked)
sf-form_radio-field
sf-checked
Radio (Checked)

sf-focus

Manage recurring focusing for button, radio and checkbox states.
sf-form_radio-field
sf-focus
Radio (Focused)
sf-form_checkbox-field
sf-focus
Checkbox (Focused)

sf-hide

Manage hidden states.
sf-skeleton
sf-hide
Loader Box (Currently Hidden)

sf-await

Manage awaiting states.
sf-button-child
sf-await
sf-button-await-child
sf-await
Awaiting Status of Buttons
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Next:

Finish your medical assessment to get Locklab

Answer a few quick questions and a Locklab physician will determine if treatment is right for you.
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Your birth date should be in MM-DD-YYYY format.
Please choose a state.
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(We will send a 6 digit code to verify)
Enter your phone number.
Please confirm your consent to proceed.
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As part of our efforts to ensure patient safety, we need to verify your phone number. By giving us your phone number and continuing, you agree that Locklab may send text messages to you to verify your phone number and for any other lawful purpose related to your Locklab account and your use of our services, including order confirmations, shipment notifications, and messages from your provider. Message and data rates may apply. Message frequency varies. Reply HELP for help. Reply STOP to opt out.
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We want to know what has or hasn't worked in the past.
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Anything else we should know about?
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Please list the names, dose, and frequency for each medicine or supplement.
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    Enter your medications
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    Include any allergies to food, dyes, prescription or over-the-counter medicines (e.g., antibiotics, allergy medications), herbs, vitamins, supplements, or anything else.
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      Enter your allergies
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      Before we finish up
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      This field is empty
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      End
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      Identity Verification

      Please provide the last 4 digits of your social security number

      To continue with treatment, we need to verify your identity.

      Why do we need this?
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      Don't want to provide this? You can upload a photo of your ID instead.
      Identity Verification

      Let's ensure you are who you say you are

      Our providers and pharmacy need one photo of your government-issued ID card - a driver's license, passport, or state ID card is best.

      We only use this information for identity verification and prescribing purposes.
      Upload Photo of ID
      (File size limit: 10MB)
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      Remove
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      256-BIT TLS Security
      HIPAA Compliant
      Assessment completed
      Identification confirmed
      Final step!

      Please confirm your email

      Your provider will send you important updates on the status of your prescription.
      Please check your spam folder if you have not received your confirmation email.