Requesting Medical Equipment Is Simple and Easy

Need a wheelchair or other medical item? Just click the PDF form below, print it out, fill it out and either fax it to 770-491-0026 or scan and e-mail it to We will call you when we have something ready for you and some items do have waiting lists.

Download the form.

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Provided hospital bed “Exceptional! Extremely helpful!”

Jennifer HernandezSugar Hill, Georgia
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