Physician Resources

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.
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Face-To-Face Guidelines For Providers
Face-to-face guidelines for prescribing providers.
Download
Tens Units Physician's Order
Physician's request for TENS unit.
Download
Vacuum Therapy Pump Physician's Order
Detailed written physician order, prescription, & letter of medical necessity.
Download
Physician's Order Generic
Generic physician's order.
Download
Physician's Order Wrist Splints
Physician's order form for wrist splints.
Download
Burge Notice Of Privacy Practices 2016
Privacy practices and disclosures.
Download
Dispensing Order - Multi Product List
Physician's order for multiple products.
Download