All Star Medical     

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6808 Alamo Downs Parkway* San Antonio, Texas 78238* Phone: (210) 767-8004 Fax: (210) 767-8024

 Referral Form

• Blank Referral Form

 Bath Chair

• Blank Bath Chair Justification Form

• Bathing System (Sample Letter)

 Car Seat

• Blank Car Seat Justification Form

 Equipment

• Blank Equipment Justification Form

• Blank Stroller Justification Form

• Strollers (Sample Letter)

• Tricycles (Sample Letter)

 Floor Sitter/Corner Chair

• Blank Floor Sitter/Corner Chair Justification Form

 Helmet

• Blank Helmet Justification Form

 Hospital /Adaptive Safety Bed 

• Blank Adaptive Safety Bed Justification Form

• Blank Hospital Bed Justification Form

• SleepSafe Beds and Custom Wheelchair (Sample Letter)

• SleepSafe Plus Bed (Sample Letter)

• SleepSafe Hi Lo (Sample Letter)

• SleepSafe Hi Lo Bed (Sample Letter)

 Patient Lift

• Blank Patient Lift Justification Form

 Portable Ramp

• Blank Portable Ramp Justification Form

Positioning Chair

• Blank Positioning Chair Justification Form 

 Stander

• Blank Stander Justification Form

• Squiggles Stander (Sample LMN)

• Gazelle Stander (Sample LMN)

• Standers (Informational Piece)

• Adult Sit to Stand Standers (Sample Letter)

• Youth Sit to Stand Standers (Sample Letter)

• Dynamic Standers (Sample Letter)

• ECI Sit to Stand Stander (Sample Letter)

 Gait Trainer

• Blank Gait Trainer Justification Form

• Gait Trainers (Sample Letter)

 Forearm Crutches

• Blank Forearm Crutch Justification Form

 Toileting System

• Blank Toileting System Justification Form

• Toileting System (Sample Letter)

 Walker

• Blank Walker Justification Form

 Wheelchair Evaluation

• Blank Medicaid Wheelchair Evaluation

• TrueTrack Driving System (Informational Piece)

• Pediatric Head Array Driver Control (Sample Letter)

• Power Seat Elevator (Informational Piece)

• Wheelchair Standers (Informational Piece) 

• Power Seating (Informational Piece)

• Manual Tilt in Space with Molded Seating (Sample Evaluation)

• Permobil Front Wheel Drive (Sample Letter)

• Powerchairs (Informational Piece)

• PowerTiger Rear Wheel Powerchair w/Head Array (Sample Letter)

• TDX Mid-Wheel Drive Powerchair (Sample Letter)

• Titanium Folding Wheelchairs (Informational Piece)

• Titanium Rigid Wheelchairs (Informational Piece)

• Titanium Wheelchairs (Sample Letter)

 Spinergy Wheels

• Spinergy Wheels (Informational piece)