VNS Therapy Patient Authorization Form

Thank you for your interest in VNS Therapy. Please provide the required information below, and a member of the VNS Therapy Patient Team will contact you.

Learn more about VNS Therapy
Download Patient Form (.pdf)

If you would like to speak to a member of the VNS Therapy™ Patient Team or are having trouble completing this form, please call 1-888-867-7846.