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PATIENTS HEALTHCARE FORMS

Here are our current healthcare forms, Adobe Acrobat Reader is required to view and submit the forms to us.

Diabetic Footware

  • Diabetic Footwear Order Form
  • Instructions For Physician to order shoes

Respiratory Forms

  • Oxygen Requirements Quick Reference
  • Respiratory Assist Device (RAD) Chart

Nebulizer Forms

  • Pediatric Nebulizer Closet Prescribing Instructions
  • Nebulizer Reorder Form

Mobility Forms

  • Dear Physician Letter for Power Mobility Devices
  • Clinical Criteria for MAE Coverage
  • Step by Step Consumer Guide to Medicare Coverage

Mobility Forms

  • Physician’s Guide for: Power Mobility Device Flow Chart
  • PWC Policy Written Prescription
  • Physician’s Power Mobility Device Reference
  • Wheelchair Measuring Chart

King Drug & Home Care is accredited by the Accreditation Commission for Health Care

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Copyright © 2022 King Drug & Home Care. All rights reserved.

Philips Respironics announced a voluntary recall for Continuous and Non-Continuous Ventilators (certain CPAP, BiLevel PAP and Ventilator Devices) due to two issues related to the polyester-based polyurethane (PE-PUR) sound abatement foam used in these devices. For information on the Recall Notice, a complete list of impacted products, and potential health risks, visit philips.com/src-update. Please contact our office with any questions.

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  • Online Bill Pay
  • Order CPAP Supplies
  • Refill Prescriptions
  • Services
    • Pharmacy
    • Respiratory Care
    • Home Medical Equipment
    • Power Mobility
  • Location
  • Resource Center
    • For Patients
    • Physician Healthcare
    • Video
  • Careers
  • About Us
  • Contact Us

Send us an email

Call us (800) 489-2609

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