Alabama Wheelchair Specialists
Wednesday, February 22, 2012
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Forms
Here are some forms that you can print for personal use:
Intake form.doc
Physician documentation request letter
Power documentation requirements
Home assessment for powered mobility
7 Element Order
Privacy practices.doc
Complaint notification.doc
Physician detailed written order.doc
Letter of medical necessity and chart notes.doc
Medicaid required wheelchair evaluation form for PT or OT
Feel free to fax any of these to us at
(205) 322-3253
. Questions? Call
(205) 322-3250
.