Opry Medical Group strives to take the hassle out of ordering medical equipment’s. We try to handle as much of the paperwork as possible for our customers.

To process your order, however, and to meet the requirements of your health insurance provider, we may need you to complete one or more of the following forms.

The most common forms we may request from you, your doctor or individuals with a Linked Account:

Patient Authorization Form

Click here to start downloading the document.

Physician Fax Order Form

Click here to start downloading the document.

Allows Opry Medical Group to discuss your order with the necessary parties, such as your doctor and health insurance provider, and gives us permission to bill your health insurance provider for your supplies.

Advance Beneficiary Notice (ABN)*

  • For Medicare customers, to confirm that you want to order an item not covered by Medicare by paying out-of-pocket.
  • To confirm that you wish to order supplies that may not be reimbursable through Medicare and you acknowledge that you are responsible for paying these out-of-pocket costs.
  • To verify that you want to order supplies other than those provided by your home health nurse or other health care professional and that you will be paying out-of-pocket for those supplies.

*This form is not available for download. It will be provided to you by our Health Advocates, when necessary. 

Physician’s Written Order (PWO)*

To confirm your doctor’s prescription. Opry Medical Group will work with your doctor to obtain the PWO. In some cases, the doctor may request that the patient bring in the blank PWO for him or her to fill out and submit.

*This form is not available for download. It will be provided to you by our Health Advocates, if necessary.

When finished filling up the forms, you may save it and email it to us at info@oprymedicalgroup.com or fax it to (866) 751-6092.

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