Prescription-Order Form (PDF) - Use this simple one-page form to order and prescribe a jaw motion rehab or CPM system. Includes doctor details, certificate of medical necessity, and prescription, and patient details and insurance information.
Referral-Order Form (PDF) - Therapists and other providers (SLP, PT, RNs) can use this simple one-page form to create a referral for an OraStretch® press or TheraBite jaw motion rehab system, with or without a prescription. Form includes referring provider details, doctor details, and patient details and insurance information.