Referral Forms
Obtain Referral Form From Nationwide Medical Supply To Help Your Patients Obtain Equipments
At Nationwide Medical Supply, we make it easy for healthcare providers to refer patients for Durable Medical Equipment (DME). Our streamlined process ensures fast, reliable service so your patients get the equipment they need without delay.
Submit a Referral via Fax
- Download and complete our DME Referral Form.
- Fax the completed form, along with the patient’s face sheet and recent chart notes, to: (630) 716-3532
Follow-Up Support
If you have questions or need to check the status of a referral, our team is here to help. 📞 Call our Referral Support Line at (630) 242-5266
Why Choose Nationwide Medical Supply?
We’re committed to working closely with healthcare professionals to ensure patients receive timely, medically appropriate equipment. Our referral process is fast, HIPAA-compliant, and supported by a knowledgeable team who understands the complexities of insurance and DME requirements.