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:: RE-ORDERS   

Use this page if you are already a customer and wish to reorder your supplies.

 
First Name: *
Last Name
 *
Address1:
Address 2
City:
State
Zip:
Phone
 *
Evening Phone
e-mail
 *
Patient ID#:
Comment:
   
 
I acknowledge receiving the last shipment. *
I request you renew my Physician's Order for the supplies.*
I will be nearly exhausted of my supplies, and require and request that you send my next shipment of supplies when due again. *
Number of Times You Test Your Blood? *
   
I need more:
Test Strips *
Lancets
 
Please select your gift
   
Please make sure all required* boxes are checked before submitting the form
 

Reorder Department can be reached at 800.876.3379

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