Documents needed for your equipment request:
Signature-on-File and Patient Administration Forms (SoF) – we need these forms to submit the claim on your behalf to Tricare directly. Please make sure both forms are hand signed and dated.
Remote Monitoring Consent Form – the device options that we provide are available with remote monitoring services; with your signature we could register your machine so sharing documentation and coordinating care is a streamlined and effective process. Your physician could monitor outcomes and change settings remotely without you having to come in for a visit. This would also allow us to access your usage and therapy reports so we can easily provide you with this information whenever needed in the future without you needing to send us your data manually. Should you be interested in the program, please sign and return the attached form to us.