Enroll in Duke Medical Supply’s Medicare Reimbursement Program

Enrolling is as Easy as 1 – 2 – 3

1. ENROLLMENT FORM

Complete the on-line Enrollment Form – OR – Download the enrollment and consent form.

Fill Out Enrollment Form

2. PATIENT CONSENT FORM

A Patient Consent Form PDF must be completed and mailed to us. The form authorizes us to obtain a prescription from your physician and also allows us to bill Medicare on your behalf.

Download Patient Consent Form PDF

3. PRESCRIPTION

When we have received your signed Patient Consent Form we will contact your physician’s office to obtain a prescription for your supplies. We will then contact you to confirm your supply preferences and the date of your first shipment.

No strings attached – No long term commitment: You may cancel or suspend your supply shipments from Duke Medical Supply at any time.

Contact Us

Our knowledgeable staff will strive to make your experience with Duke Medical Supply enjoyable and will assist you with any questions you may have about Medicare or your ostomy supplies.

Questions?

Toll Free (1-888-678-6692) -OR- Email Us

Enroll Online

Fill Out the Enrollment Form