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.



Document for Medical Evaluation (DME) Documents

MaineCare Continuous Glucose Monitor (CGM) Policy Documents

Negative Pressure Wound Therapy

Respiratory Documents