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Medical Necessity Certification Statement (AKA PCS Form)

To complete, sign and return the Certification Statement using DocuSign click HERE
To download the Certification Statement to print, complete, sign, and Fax to 414-486-6080 or 414-486-3057 or 414-486-6059 click HERE

To make a check-by-phone payment please call (414) 486-4055 and speak to one of our payment specialists.

To make an online payment using your major credit card, click here.

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