For providers
Downloadable forms.
Fillable order forms and documentation references for your office, ready to complete digitally and send back by fax or your preferred referral method.
Order forms
Download a fillable order form.
Download and complete the appropriate order form below, then fax or upload it to start a referral. Forms include fillable fields and can be completed digitally.
Back Brace Order Form
Lumbar and thoracic support
Knee Brace Order Form
Hinged, compression, and OA styles
Ankle Brace Order Form
Stabilization and compression
Wrist Brace Order Form
Carpal tunnel and immobilization
CGM Order Form
FreeStyle Libre 3 Plus
Wound Care Order Form
Surgical dressings and supplies
Completed forms can be submitted by fax to 866-292-6645 or through the referral contact methods on our For Providers page.
Helpful documentation resources
CGS Administrators reference letters.
These official CGS Administrators resources can help clarify documentation and coverage questions.
CGM Coverage & Documentation Requirements
Guidance on Medicare CGM coverage and required documentation.
Medical Records: Sharing Without Patient Authorization
Information on sharing medical records for payment and healthcare operations.
Ready when you are