Qualification Form

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By clicking the ‘Submit’ button I am providing my express prior written consent, to be contacted by Complete Medical Solutions, its agents, affiliates, contractors, or supply or service providers at any number I have provided via phone calls and/or text messaging, including calls or texts made using automated technology or pre-recorded messages. I understand that standard text and/or usage rates may apply and that I am not required to provide consent as a condition of any sale of a good or service.
Contact your physician, medical professional and insurance carrier concerning your medical necessity on products and services offered on this website. Product representation depicted on this website or actual product received may vary from pictures.
Orders must be approved medically necessary by a doctor or medical professional. Little or no cost with primary and supplemental insurance and co-pays and deductibles apply.Your insurance must be eligible to qualify. If you are not eligible to receive benefits, you will be advised on various other options to receive these products. Giving consent is not a condition for making any purchase. Your consent may be revoked at any time. Call 800-913-6052 to be removed.