The following forms and documents are intended to help doctors properly fill out the required paperwork for our patients according to Medicare and insurance provider guidelines.
- Physician's Order For Repair
- Physician's order for power wheelchair repair.
- Face-To-Face Guidelines For Providers
- Face-to-face guidelines for prescribing providers.
- Tens Units Physician's Order
- Physician's request for TENS unit.
- Vacuum Therapy Pump Physician's Order
- Detailed written physician order, prescription, & letter of medical necessity.
- Physician's Order Generic
- Generic physician's order.
- Physician's Order Wrist Splints
- Physician's order form for wrist splints.
- Burge Notice Of Privacy Practices 2016
- Privacy practices and disclosures.
- Dispensing Order - Multi Product List
- Physician's order for multiple products.