Forms

Below are forms you may need to help us process your order quickly and accurately.

Authorization to Bill
As a participating provider for Medicare Part B, most state Medicaid programs, and multiple commercial insurance plans, we file claims on your behalf. You will receive this form in your first shipment of supplies. Please sign it and fax or mail it back to us in the postage-paid envelope provided. If you need help completing this form, please contact the NationsHealth Customer Service Department at 1-800-644-1050.

If you would like to complete this step now, please download and print the document below, sign it, and fax to 1-800-977-0601 or mail it back to us at:

NationsHealth
PO Box 267971
Weston,FL33326-9895

Authorization to Bill Form (35k)

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Doctor's Orders
NationsHealth obtains the required authorization from your doctor before shipping your supplies.

The forms below are our Doctor's Order form for supplies. These forms must be completed by your doctor, signed, and faxed or mailed back to us before we can ship your supplies.

In order to ensure timely processing, please advise your doctor to expect an authorization form from NationsHealth. This notice should give your doctor sufficient time to provide the necessary documentation authorizing us to ship your supplies.

Download Diabetes Doctor's Order Form      Download Ostomy Doctor's Order Form

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