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    • Home
    • About Us
    • Service and Repairs
    • MOBILITY
    • ORTHO
    • RESPIRATORY
    • BATH AIDS
    • PERSONAL CARE
    • DAILY LIVING AIDS
    • REFERRALS
    • Contact Us
    • Resources
    • Privacy Practices
    • Return Policy

MedMart
  • Home
  • About Us
  • Service and Repairs
  • MOBILITY
  • ORTHO
  • RESPIRATORY
  • BATH AIDS
  • PERSONAL CARE
  • DAILY LIVING AIDS
  • REFERRALS
  • Contact Us
  • Resources
  • Privacy Practices
  • Return Policy

Referral Form

Email referral form to info@trust-med.com or fax to (210) 697-8753. 


Please include notes relevant to the ordered equipment and copies of the patient's insurance card (front and back).


We look forward to working with you!


Referral Form San Antonio (pdf)Download
Referral Form Eagle Pass (pdf)Download
Referral Form Laredo (pdf)Download
Title XIX v10-2024 (pdf)Download
Title XIX Addendum v10-2024 (pdf)Download

COVID-19 has created unprecedented DEMAND FOR MEDICAL EQUIPMENT AND SUPPLIES. Availability & pricing are subject to change without notice due to high demand, limited supply & cost changes. We reserve the right to limit quantity, frequency of purchase and discounts on any items.

Copyright © 2020 MedMart - All Rights Reserved.

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