Medical Professionals - fill in and/or choose what is correct. We will analyze (based on a comparison of the patient's diagnosis, device indications for use and insurance coverage) and reply ASAP with recommendation and appropriate CPT codes if requested. Or, simply enter order directly by clicking on box at right of equipment list below.

If you are searching for Clinical Equipment, please describe in detail below in diagnosis box or what you need i.e. type, make, model etc., and we will respond ASAP.

So please fill in your E-mail address (or name and number) below. Or, simply fax patient's face sheet to 800-682-4077 (in Miami 305-895-9095).

Alternatively, please us with diagnosis, treatments applied (their relative success), and type of insurance and we will respond with options available.

Please - Utilize Form:

Your E-Mail address here

Please provide your patient's diagnosis/prognosis w/ notes and/or any comments below: (Also, if you would like to be added to our referral base for patients requesting Physician please indicate below by including Name, Address, Phone #, Zip and Web Site.)

What type (s) of treatments have already been utilized? Click on initials for device information and/or choose by clicking box at right of description:

	MANS - Muscle and/or Peripheral Nerve Stimulation
	EDA - Electronic Dental/Medical Anesthesia
	CLP - Calibrated ( gradient,sequential ) Lymph Pumps
	CPM - Continuous Passive Motion (all joints)
	HVPG - High Volt Pulsed Galvanic
	LVG - Low Volt Galvanic
	EMG - Electromyography
	EMS - Electrical Muscle Stimulator
	BGS - Bone Growth Stimulator
	FES - Functional Electrical Stimulation
	IFS - Interferential Stimulation
	MENS - Microcurrent Electrical Stimulation
	TENS - Transcutaneous Electrical Nerve Stimulation
	All Stimulator Electrodes and Leadwires, Cryo-Therapy, Dynasplints, Nebulizers, Wound Care, Diabetic Supplies, Respiratory Care and all accessories...

Were treatments (if any) successful? Please elaborate:

What type of insurance does the patient have?:

Thank you for utilizing our 20 years of DME experience!