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                Get Rebel Reliever Order Form
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How to fill out the Rebel Reliever Order Form online
Completing the Rebel Reliever Order Form online is a straightforward process designed to help users efficiently place orders for OA knee braces. This guide will outline each section of the form, providing clear and detailed instructions to ensure a smooth experience.
Follow the steps to fill out the form online.
- Press the 'Get Form' button to access the Rebel Reliever Order Form, which you will open in your online editor.
- Enter the shipping information in the 'Ship To' section, including the recipient's name, address, city, state, zip code, and phone number. Ensure that the details are accurate to avoid any shipping issues.
- Fill in the 'Ordered by' section with your name and contact details. This information is essential for tracking and communication regarding the order.
- In the 'Billing' section, provide the billing address and any required identifiers, such as a purchase order number or Townsend account number, to facilitate accurate billing.
- Specify the patient's name and the fit date, if known. This information allows for timely coordination of fitting the knee brace.
- In the 'Rebel Reliever' section, select the compartment (medial, lateral, or universal) and leg (right or left) for the brace. Ensure that the correct options are chosen based on the patient's needs.
- Choose the brace size from the provided options, noting the leg length and measurements. For customized braces, fill out the measurements as instructed related to the thigh shell and circumference.
- Select any additional options or features, such as the compression/suspension package or flexion stop kit. Be aware that extra charges may apply.
- Review all fields to ensure accuracy and completeness. Make any necessary edits to avoid future complications.
- Once all information is filled, save your changes. You can then download or print the completed form directly from the editor or share it via email.
Complete your Rebel Reliever Order Form online today for prompt and efficient processing.
Related links form
CPT code L1850 refers to a specific type of knee brace that offers significant support. Understanding this code is crucial for proper documentation and payment processing. Familiarity with various CPT codes helps simplify your healthcare journey. For assistance with these codes, explore the features available on the Rebel Reliever Order Form.
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