How to write a tens unit prescription: Fill out & sign online

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Click ‘Get Form’ to open the tens unit prescription form in the editor.
Begin by entering the 'Date of Order' at the top of the form. This is essential for tracking the prescription timeline.
Fill in the 'Patient Demographics' section, including Name, Sex, Date of Birth, Address, City, State, Zip Code, and both Home and Work phone numbers. Ensure accuracy for effective communication.
In the 'Referring Physician Demographics' section, input the Physician's Name along with their UPIN and NPI numbers. This information is crucial for insurance processing.
Select the prescribed items from the 'Items Prescribed' section by checking the appropriate boxes for equipment and supplies needed.
List any qualifying diagnoses in the designated area. This helps justify the medical necessity of the TENS unit.
Finally, ensure that you have a space for the Physician's Signature and Date at the bottom of the form before submitting it.

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