Medical information request form.
Medical Information Request Form (MIRF) is for health care professionals only.
If you are not a healthcare provider but have a question, please contact customer service.
Completion and submission of this MIRF is considered your electronic signature confirming this request was not solicited by any company representative of Elutia.
12510 Prosperity Drive, Suite 370
Silver Spring, MD 20904
Customer Service: 877-651-2628
Women's Health Products
Customer Service: 800-922-3100
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