Placing an order for urological supplies

Orders can be faxed, emailed, or mailed to us.

Fax number: 773.725.8905 (toll-free fax: 877.444.5155)
Email address:
Mailing address: 4592 N. Elston Ave., Chicago, IL 60630

The following paperwork is required to set up a new patient:

1. Patient Demographics
2. Insurance Information (if applicable)
3. Signed Prescription
4. Lab results proving two urinary tract infections (required for catheter kits only)
5. Letter of medical necessity (required for catheter kits only)