Please provide a description of the changes you wish to make to your allocation request. After you submit this form, a member of the NC DHHS COVID-19 Treatment team will make the requested changes and notify you when complete.
Please use the following format in the box below (you can copy and paste and edit the areas highlighted in yellow):
To Update a Request: "I need to change my current request for (Current Quantity Requested) courses of (Current Product Requested) to (Detail Requested Change)"
To Cancel a Request: I need to cancel my pending request for (Current Quantity Requested) courses of (Current Product Requested)