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 – Call us toll free at (1-888-678-6692) to request an 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
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.