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“Blue Jay Reusable Absorbent Underpad” has been added to your cart.
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Product
Price
Quantity
Subtotal
Blue Jay Premium Arthritis Compression Gloves
$
50.00
Blue Jay Premium Arthritis Compression Gloves quantity
$
50.00
Semi-Solid Ankle Foot Orthosis Drop Foot Brace Medium Right
$
34.59
Semi-Solid Ankle Foot Orthosis Drop Foot Brace Medium Right quantity
$
34.59
Blue Jay Reusable Absorbent Underpad
$
15.00
Blue Jay Reusable Absorbent Underpad quantity
$
15.00
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Order Summery
Subtotal
$
99.59
Total
$
99.59
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Workers Comp Claim Insurance Purchase Request
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(Required)
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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)
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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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(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
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