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US MED
Reorder Catheters

Please fill out the form below to reorder your Catheters.

 

First Name:
 
Last Name:
 
Email: (Example: name@emailbox.com)
 
Phone Number: (XXX-XXX-0000)


(Please use the number we have on file for you)
 
Account Number: (optional)
 
How many times per day are you cathing on average?
 
Are you having trouble cathing due to a blockage and if so, would you like to try a Free Coude catheter sample?
 
Have you had 2 or more Urinary Tract Infections in the last year and if so, would you like to try a Free Closed System Catheter Kit which comes with a drainage bag and will reduce infections?
 
Are you almost out of Catheters?

 
 
If any items such as address, doctor, or insurance has changed, please tell us what has changed and the new information below:
 

I acknowledge receiving my last shipment. I am nearly exhausted of my supplies, and require that you send my next shipment of supplies when due. I acknowledge receiving the supplier standards, warranty info and training materials. I authorize the company to renew my prescription, to verify my insurance benefits, to contact me, to request and accept the release of my relevant medical records, and to submit claims and claim assignment of payments of medical benefits for items/services provided to me.

 
 

 

 

Not Yet a Customer?
Contact Us Today
at 1-877-840-8218

 

FIND OUT MORE:
First Name:
Last Name:
Phone: (e.g. ###-###-####)
Email:
I'm interested in:
Diabetic Supplies
CPAP Supplies & BiPAP Masks
Breathing Medications & Nebulizers
Urological Catheters
Braces: Back, Ankle, Knee, Wrist
Other Products
US MED and its affiliates may occasionally have products or services that we think may be of interest to you. By pressing the Submit button above, you give us your consent to use automated technology to call you at the phone number(s) above, including your wireless number if provided. Please note that you are not required to provide this consent to make a purchase from us.
 

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US MED
8260 NW 27th Street, #401 Doral, FL 33122

Current Patients Call:

1-877-USMED-98 (877-876-3398)

New Patients Call:

1-877-840-8218

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