-
Category A - Underwear/Pull-Ups - 192 / Month *Size 2XL Max 180 / Month
-
Category B - Diapers(w/tabs) - 192 / Month *Size 2XL Max 180 / Month
-
Category C - Urinary Pad/Booster/Liner - 192 / Month
-
Category D - Disposable Gloves & Sanitary Wipes (Prior Authorization)
-
Category E - Disposable Bed Pads - 150 / Month
Combination of above:
Total Max Combined per month between Pull-Ups (A) and Diapers W/Tabs (B) and Urinary pads (C) = 192
- i.e 60 Pull-Ups, 60 Diapers W/Tabs, 60 Urinary Pads
***Filling out the product form:***
- Select the check box next to each item you wish to order. ALL products have been pre-selected for you.
- For each product selected, please select the appropriate type, size, quantity and absorbency.
- Products you do not want included on your order, please unselect the blue check box.
- Click "SUBMIT" when completed.
Please Note: Gloves, wipes and bed pads must be selected with either pull ups, diapers with tabs or urinary pads.