Diabetic Solutions Delivers diabetes supplies and Medical equipment including wheelchairs,power wheelchairs,diabetic shoes,walkers,arthritis relief t pumps,and great variety of medicare,medicaid covered medical equipment.

MT.EMEY WOMENS PREMIER COMFORT DIABETIC SHOES 9209

MT.EMEY WOMENS PREMIER COMFORT DIABETIC SHOES 9209
Item# 9209MTEMEY
SIZE:  COLOR:  WIDTH: 

Product Description

MEDICARE?YOU MAY QUALIFY AT NO COST TO YOU!!! (915)881-0800 Fill out Medicare form and an expert will contact you to help you find your best option of coverage.

Your Name:

Your Middle Name:

Your Last Name:

Gender:

Email Address:

Address:1

Street Address:2

City:

State:

Zip Code:

Phone Number:

Alternate Phone Number:

Physicians Name:

Physicians Phone Number:

Medicare Number:

Enter Secondary Insurance Carrier:

Enter Social Security Number (000-00-0000):

How often do you test your blood sugar level?
1 time daily
2 times daily
3 times daily

Date Of Birth:


HAVE YOU RECEIVED MEDICAL EQUIPMENT COVERED BY MEDICARE LIST ITEMS AND DATE RECEIVED,INCLUDE E-MAIL?:



Diabetic Solutions And Medical Supply delivers quality diabetes supplies and Medicals equipment 100% satisfaction guarantee.