Patient Forms

In order for us to bill your insurance for any of the products we carry we must have:

*A completed Patient Information Package (PIP) 

*Copies of your insurance cards

*Prescription from your doctor. 

 

Below we have included the Patient Information Package (PIP) available for download for your convince.

*By signing the PIP you are certifying that you have received the Patient Rights and Responsibilities package*

Patient Information Package

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Patient Rights and Responsibilities

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