CMS Rx

Bandage Order Form

Comprehensive Care Center for Women

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Bandage Orders

New Patients

New patients in need of compression bandages will need to supply the following documentation in order for CMS to process your request:

  • A signed Rx that includes your diagnoses

  • A completed New Patient Registration Packet

  • Bandage order form specifying the exact bandages and quantity you need (click here)

  • Shipping fee (if you choose to have your bandages shipped directly to you)


Existing Patients

Existing patients in need of replacement bandages will need to supply the following documentation in order for CMS to process your request:

  • An updated Rx that includes your diagnoses

  • Bandage order form specifying the exact bandages and quantity you need (click here)

  • Shipping fee (if you choose to have your bandages shipped directly to you).

 
 


 

 



  

Ph. 1.877.CMS.4415          Copyright 2008          Compression Management Services, Inc         All Rights Reserved