Professional Resources

Single Product Prescriptions & Order Requirements

TENS

• Prescription Form – TENS
• Order Requirements – TENS

NMES

• Prescription Form – NMES
• Order Requirements – NMES

Pelvic Floor

• Prescription Form – Pelvic Floor Stim
• Order Requirements  – Pelvic Floor Stim

Bone Growth Stim

• Prescription Form – Bone Growth Stim
• Order Requirements – Bone Growth Stim

Step-Smart for Drop Foot

• Prescription Form – Step-Smart AFO
• Order Requirements – Step-Smart AFO

Hybrid Night Splint & Walker Boots

• Prescription Form – Hybrid Night Splint & Walker Boot

LSO, TLSO, & Peak Scoliosis

• Prescription Form – LSO & TLSO
• Order Requirements – LSO
• Order Requirements – TLSO
• Order Requirements – Peak Scoliosis Brace

Knee Orthosis

• Prescription Form – Knee Orthosis
• Order Requirements – Functional Knee Brace (Ligament)
• Order Requirements – Unloading Knee Orthosis

Cervical Traction

• Prescription Form – Cervical Traction
• Order Requirements – Cervical Traction

Knee Scooter

• Prescription Form – Knee Scooter

Breast Pump

• Prescription Form – Breast Pump

Blank Prescription (Fillable Product & HCPCS Code – Use for shoulder braces, ankle braces, neck braces, etc.)

• Prescription Form – Generic (Fillable Product & HCPCS Code)