Go to Production

The activation checklist

1. Add a card. Your card is kept on file for prepaid-credit charges. Nothing is charged before you're approved — credits are purchased after approval.
2. Verify your identity. You — the developer — verify your own identity via Stripe Identity.
3. Accept the developer terms.
4. Request production access. We review and approve (manual review at launch). You'll get an email when you're live.

After approval

Buy an initial credit balance from the Billing & credits card on your dashboard, and configure auto-refill (optional but recommended) so submissions never bounce on an empty balance.

Then create a production key (ak_live_…) from your dashboard. Submissions made with it reach a board-certified physician. Everything else about the integration stays identical to sandbox.

Testing the production flow yourself

To maintain separation of concerns between developer accounts and personal accounts, a developer account cannot accept the consent modal — not even for its own app's requests. Consent to care must come from the patient, and the account that accepts it becomes the owner of the resulting medical record and the physician conversation. A developer account holds your API keys and billing, so it can never be the patient.

If you want to walk a production submission end to end, open the consent_url while signed out (or in a private window) and sign in with a personal email that is not attached to a developer account. If you're signed in as a developer, the accept step is refused and the modal offers a one-click sign-out so you can continue with a personal email. The sandbox has no such restriction — sandbox consent creates no account at all.

Acceptable use

Transmit the patient's information faithfully; don't tune narratives for a specific outcome. Appendix reserves the right to restrict indications, decline any request, or suspend access for misuse. See Consent & Identity.