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Patient Care Kits Ordering Instructions

  • Click on the "Patient Care Kit" Catalog below to see the available items

  • Click on the "Patient Order Kit Order Form" below and complete the form online

  • Please note the following

  • Minimum order for kits is 24
  • No minimum order for components
  • Online (typed) orders will be processed quickly - please, no handwritten orders
  • Credit card is required to place orders

  • Option: Save order form to your computer for future use

  • Print the order form and fax to Allergan at 1-866-257-0281

  • For questions, please call 1-800-811-4140

  • Orders received after 12 PM PST will be processed the following business day