Referrals

Bedard appreciates your referral and encourages you to use the fillable forms below.

How to use these forms
Submit your referral via fax. Simply open the form, complete all fields, then print for physician's signature prior to faxing to Bedard Pharmacy and Medical Supplies. You may also download and save the form(s) for future use. We will confirm receipt of your order.

See below for important information regarding documentations requirements.




Face-to-Face Documentation Requirements
Click on the link below to view documentation requirements:

Ambulatory & Other Aids
Respiratory
Beds & Wheelchairs
MaineCare CGM Policy