To better assist your start on the road to Electrotherapy for Pain Management and/or Muscle Rehabilitation in your home, the following questions will help determine which of the myriad of devices will best serve your therapy needs.

Please, to better serve you - fill in and/or choose what is correct. We will analyze (based on a comparison of your diagnosis, device indications for use and insurance coverage) and reply ASAP. No obligation, No cost.

Alternatively, simply us with, at least, your diagnosis and insurance type.

Please - Utilize Form:

Fill in your E-Mail address so we may reply :

Have you been under a Doctor's care for your problem? Yes No

If no to first question, would you like a Doctor or Physical Therapist's name in your area? Yes No

If yes to first question, has he/she already prescribed a device he/she recommends? Yes No

If yes, which type (s) ? Click on initials for 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...

What is your general diagnosis/prognosis (from your Doctor, if possible)?

What type of insurance do you have, if any?

Would you like us to check to see if your insurance will cover? Yes No

If yes, please include your Insurance Company's Name and yours, Telephone Number, Contact Name and your incident or group or claim number.

Upon reviewing the above information, we will assist in determining which device best fits your circumstances and is covered by your insurance ( where applicable).