We try to make ordering medical supplies as efficient and hassle-free as possible. To process your order, however, and to meet the requirements of your health insurance provider, we may need you to complete one or more of the following forms.

Consent form –allows Goldin Pharmacy to discuss your order with the necessary parties, such as your doctor and health insurance provider, and gives us permission to bill your health insurance provider for your supplies.

Doctors prescription necessary, as well as all necessary paperwork required by insurance companies.

We need to check whether or not the client has met the deductible for private insurance. If not, it is their responsibility to pay their deductible and co-pays to us.

We need signature confirmation on the delivery ticket to be mailed back immediately, or asap. Otherwise, the client is responsible for the full cost of their product.

We need the patient to fill out a patient information form, and must provide a physical and history report.

For any questions please contact us.