IF YOU ARE A HEALTHCARE PROVIDER AND WOULD LIKE TO SCHEDULE SURGERY OR SERVICE, YOU HAVE THE OPTION TO FILL OUT THE FORM BELOW. YOU MAY ALSO EMAIL YOUR REQUEST TO ORDERS@SURGICAL-SOLUTIONS.NET. YOU MAY ALSO FAX YOUR REQUEST TO 901.290.2742.
FOR IMMEDIATE NEEDS PLEASE CALL 901-244-6905
IF YOU ARE REQUESTING A BACK BRACE, BONE GROWTH STIMULATOR OR OPERATIVE MONITORNG SERVICES WE WILL BE REQUESTING ADDITIONAL INFORMATION TO COMPLETE REQUEST OR YOU CAN EMAIL OR FAX THE FOLLOWING:
- BONE STIM : PATIENT FACESHEET, COPY OF INSURANCE CARD, LAST CHART NOTE, OP REPORT IF AVAILABLE, AND PRESCRIPTION
- BACK BRACE: PATIENT FACESHEET, COPY OF INSURANCE CARD, AND PRESCRIPTION
- OPERATIVE MONITORING VIA SMP: PATIENT FACESHEET & COPY OF INSURANCE CARD