Please fill out this Letter of Medical Necessity and Prescription for Appliance Form and fax to: 713-932-9114. It is our pleasure to be part of your treatment team for your patient.
Please fill out this Letter of Medical Necessity and Prescription for Appliance Form and fax to: 713-932-9114. It is our pleasure to be part of your treatment team for your patient.
* All indicated fields must be completed. Please include non-medical questions and correspondence only.