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Product
Price
Quantity
Subtotal
Seat Only for Drive
$
39.99
Seat Only for Drive quantity
$
39.99
Gel Wheelchair Cushion
$
30.86
Gel Wheelchair Cushion quantity
$
30.86
Drive Medical Wheelchair Transport Lightweight
$
229.99
Drive Medical Wheelchair Transport Lightweight quantity
$
229.99
Drive Medical Universal Walker Tray with Cup Holder
$
54.99
Drive Medical Universal Walker Tray with Cup Holder quantity
$
54.99
HurryCane Freedom Edition Folding Cane
$
44.99
HurryCane Freedom Edition Folding Cane quantity
$
44.99
Slimline Cast Boot Black Square-Toe
$
20.25
Slimline Cast Boot Black Square-Toe quantity
$
20.25
Softie Surgical Shoe Mens
$
16.12
Softie Surgical Shoe Mens quantity
$
16.12
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Order Summery
Subtotal
$
437.19
Total
$
437.19
Proceed to checkout
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Agree
Workers Comp Claim Insurance Purchase Request
To complete this order we need some information, please fill out below to the best of your ability and our team will contact you if there are any additional requirements.
Name
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(Required)
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DD dash MM dash YYYY
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Other Claim Insurance Purchase Request
To complete this order we need some information, please fill out below to the best of your ability and our team will contact you if there are any additional requirements.
Name
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First Name
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DD dash MM dash YYYY
Insurance Type
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Mediciad
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Other
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(Required)
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(Required)
Documents Section Upload (i.e. prescriptions)
Max. file size: 2 GB.
I agree to allow CapsuleAID and its authorized representatives to contact me about my medical supplies, orders, and related subject.
(Required)
Agree
Best Sellers
Gel Wheelchair Cushion
$
30.86
Drive Medical Silver Sport 1 Wheelchair – Durable and Lightweight
$
194.99
Toe Alignment Splint
$
20.11
Drive Medical Deluxe Folding Walker, Two Button
$
62.99
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