Order Form

 

Product / Service

 Rate

Policy and procedure manual Version I (for full service providers)

$685.00

Policy and Procedure manual Version II (for pharmacies and specialty providers - no oxygen or respiratory products)

$685.00

Accreditation Do It Yourself Kit (includes policy / procedure manual, patient education guides, HIPAA, and phone consultation) $1195.00

Patient equip education guides /patient orientation checklists

$200.00 full set

Intake and Billing Training Manual

$150.00

HIPAA Privacy Manual for HME Providers

$200.00

Home ventilation manual patient teaching manual

$145.00

Disease management programs (CHF or COPD)

Call

Staff education and training manual

Call

 

All written materials are provided in hard copy and on computer media, suitable for editing. Mail completed form to address below, or call (425) 882-9706 for more information

 

Domos HME Consulting Group copyrights all written materials. Rights are granted for distribution within your organization only. Material may not be resold without the written permission of Domos HME Consulting Group.

Please provide the following ordering information:

ITEM DESCRIPTION

QTY

 

 

 

 

 

 

 

 

 

Subtotal

 

 

 

 

Shipping (priority mail)

$20.00

Enclose check for this amount, please:

Total

 

Shipping Address

Company Name:

 

Attention:

Street Address:

 

Phone:

 

City:

 

State:

Zip:

Mail to: Domos HME Consulting Group   
               18300 NE Union Hill Rd, Ste 248                                
               Redmond, WA 98052