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     Getting Liberty
   
   
   
   
   
Getting your LibertyŽ Pelvic Floor Stimulation Therapy System is as simple as  1,  2,  3.  Just follow the easy ordering instructions.


  Step 1

 Download and Print Documents

The LibertyŽ PFS System is available by prescription only. Download and print the LibertyŽ Information Packet (contents: clinical brochures, order form and letter of medical necessity to take with you when you talk to your doctor about LibertyŽ.
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  Step 2

Discuss LibertyŽ with your Doctor

 Use these materials to talk to your primary care doctor, gynecologist or urologist about how the LibertyŽ PFS System can help treat your urinary incontinence condition, and request that your doctor prescribe LibertyŽ for you.

You or your doctor can contact a LibertyŽ Support Specialist toll free at 1.800.533.4984 x 4109 (M-F, 8:30am - 5:30pm Mountain Time) with any additional questions.
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   Step 3

Order your LibertyŽ PFS System

 All orders require payment before the LibertyŽ System can be shipped.

On the LibertyŽ Order Form:

1. Complete the "Patient Information" section. All information is necessary to properly process the order.

2. Read and sign the "Purchase Agreement" section.

3. Your doctor should complete the "Prescription Information" section.

For Medicare claims, you must ALSO provide:

1. The Letter of Medical Necessity
completed by your physician.

 2. Copies (both sides) of your current insurance cards.

3. Any additional documents as listed on the Letter of Medical Necessity.

Mail, fax or email all forms with down payment by credit card or check(mail only) to:

Liberty Order
Utah Medical Products, Inc.
7043 South 300 West
Midvale, UT  84047

 Fax: 1.801.566.2062

Email: liberty@utahmed.com

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   Some private insurance companies cover a portion of the cost of the LibertyŽ PFS System. Contact a LibertyŽ Support Specialist or your insurer if you have any questions about your insurance coverage or filing a claim.


  How does Utah Medical Products, Inc. handle your information? Read our Health Information Privacy Notice.


  For help in any part of the ordering process, contact a LibertyŽ Support Specialist.
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