(248) 354-5200Novi, Michigan
24/7 Service Available
Phoenix Medical Supply, Inc. — The Difference Is Caring

PHYSICIAN ORDERS

Wheelchair Order

Manual or power wheelchairs and mobility aids. Submissions route directly to our intake team. Questions? Call (248) 354-5200.

Wheelchair Order

Complete the patient, equipment and physician sections below.

PATIENT INFORMATION

CLINICAL & EQUIPMENT

ORDERING PHYSICIAN

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