WANT TO SAVE TIME?

To simplify and make the ordering process as easy as possible, complete our online Express Verification Form. Or, you may fax your own computer-generated (or handwritten) demographic sheet for each patient to 800-717-2573. To submit orders using our paperwork, login below.

Log in below to obtain Patient Forms

If you do not yet have a user ID or password, please call us at 516-586-4934 or email us at info@smgmediquip.net.





Contact Us

SMG Mediquip, LLC
P.O. Box 736
Bethpage, NY 11714
516.586.4934 (phone)
800.717.2573 (fax)
800.211.0404 (fax)
info@smgmediquip.net