Rehab Supply Useful Forms

Rehab Supply, LLC prescription forms for physician use.  Easy way to prescribe your patient an electrotherapy unit or the patient can print out and take it to their physician. All of these forms are provide in Adobe Acrobat / PDF form.

Prescription / Letter of Medical Necessity (LMN) Forms

Electrotherapy LMN Form

Conductive Garment LMN Form

Saunders Cervical Traction LMN Form

Pronex Cervical Traction LMN Form

Saunders Lumbar Traction LMN Form

Soft Goods / Bracing LMN Form

PreCert Form

Rehab Supply, LLC precert form for clinician or patient use.  Easy way to provide us with the required information to check benefits & eligibility for a patient before dispensing an item to them.  Fax it in with a prescription to obtain the fastest service.

PreCert Form