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For your convenience we have provided two simple methods to get your clients' information to us.
1) A basic Word document
Client Referral doc
Simply download the file to your computer
Print it
Complete all applicable fields
Fax the form to us at 1-877-531-1854
2) Form Files Referral Form doc
Referral Form pdf
Save this file to your computer
Enter your information
Enter your clients' information
Re-save the file (with a name and location easily remembered)
Open your email program
Type NursingStaff@personalcareproducts.biz
in the "To" field
Attach the re-saved file to your email
Send the email
Your clients will be contacted immediately by competent and courteous staff members to process the request.
Should you have any questions or require assistance with these documents, please call us at 1-800-575-0302.
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