Activstyle Order Form
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According to information supplied by the company, activstyle offers delivery of medical and incontinence supplies to consumers in their homes. Newordercm@activstyle.com fax completed form to: We provide a comprehensive set of continuous glucose monitors (cgm), insulin pumps, and related supplies from the industry’s leading manufacturers. Promptly complete, date, sign and return each delivery confirmation when required by your insurance provider.
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Web we’ll handle all the details for you — like contacting your doctor for a prescription and processing the insurance forms. Web this form is for healthcare professionals or case managers to make patient/client referrals to activstyle. Collect your information we will first get some basic information from you to enroll in our program and complete your order.