110 Osigian Blvd
 
Warner Robins
 
478-953-2922
 
 
Document Details
Details for Diabetic Shoe Authorization Form
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Name Diabetic Shoe Authorization Form
Short Description
Description The PDF file contains two Diabetic Shoe Authorization forms that are to be taken to your medical doctor (MD or DO) that checks your blood sugar levels. Shoes/inserts can be prescribed by your foot doctor, but this form must be completed and signed by your doctor to be able to bill your insurance. We must have the original signed form prior to delivery of items ordered.
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Filetype pdf (Mime Type: application/pdf)
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