Diabetic Reorder Form

Patient Resources

  • Reorder Products
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Diabetic Reorder Form

Are you testing according to your prescriber’s orders?

Your insurance records show that you are eligible to receive new diabetic supplies, if you need them. Your insurance carrier requests we document the number of supplies you have on hand. Do you have less than a 2 week supply of your normal diabetic supplies and would you like to order new supplies?

Have you changed to a new brand or model of meter since your last order?

Have there been any changes to your insurance, doctor, doctor's orders, or your address since the last time we contacted you?

4 + 3 =

Or if you’d prefer, just call us:

Priority Patient Care is Our Mission



140 N 2nd Street, Suite 3 Stroudsburg PA 18360