Referrals

How to use these forms

Submit a referral via fax. Simply open the form by clicking on it, complete all fields, then print for physician's signature prior to faxing to Bedard Pharmacy and Medical Supplies (207-784-7992). The forms may also be downloaded and saved for future use. Bedard will confirm receipt of your order.


 

CPAP & BiPAP

Document for Medical Evaluation (DME) Documents

MaineCare Continuous Glucose Monitor (CGM) Policy Documents

Negative Pressure Wound Therapy

Respiratory Documents