Request your SYNVISC® New Account Kit by filling in the fields below. Before you click "Submit," please indicate whether you would like to receive your kit by fax or email.

Your kit contains a credit application that you'll need to complete and fax or mail back to us. We will process it within two business days. Once your credit application has been approved, we will send you a confirmation email with your new account number and an order form.

Questions about setting up your account?
Call 1-888-3-SYNVISC (1-888-379-6847), M-F, 8am-8pm (EST) to speak to a customer service representative.