Order Forms
Downloadable Order Forms
On this page, providers will find a fillable standard written order form for compression garments, along with some additional information that can assist them in placing orders. This information is available for download.
Once filled in, please submit it by fax: (805-782-9700) or email: orders@cclymph.com.
Compression Garments Standard Written Order
Compression Garments Standard Written Order. This is the only necessary order sheet to submit for patient orders.
Compression Garments Measuring Guide
A set of optional measuring guides that can be used to provide us with accurate measurements for your patient’s compression garments
Detailed Upper Body Order List
A supplemental sheet to make ordering upper body compression garments easier
Detailed Lower Body Order List
A supplemental sheet to make ordering lower body compression garments easier
Email orders@cclymph.com your completed forms
or Fax them to 805-782-9700
Frequently Asked Questions
Do you provide compression garments to non-Medicare patients?
We do provide compression garments to non-Medicare patients. Our primary focus is on Medicare patients as they recently began covering compression garments, but we have had success with some other insurances and provide self-pay options.
How many compression garments will insurance cover?
Medicare currently covers three daytime compression garments every six months per body part. They also cover an additional two nighttime compression garments every two years. For all other insurance plans, including Medicare Advantage plans, we need prior authorization for compression garments. We encourage providers to submit orders even if unsure whether insurance will cover the garment. We are happy to work with all patients to provide compression garment needs.
Do patients have to pick up their compression garments, or can you have them delivered to their home?
We offer both home delivery and pickup at our San Luis Obispo office for compression garments. After we receive the standard written order, we will reach out to the patient and discuss with them their preferred method for receiving their compression garments.
Do you accept orders without measurements taken?
Yes, we do. We are happy to work with the patient to figure out proper sizing for the garments. The current required fields for our Standard Written Order are:
- Patient’s Name
- Primary Phone
- Diagnosis
- Duration of Need
- General Description of the Item (including body location and side if applicable)
- Quantity
- Provider’s Name
- Provider’s NPI
- Provider’s Signature
What compression level should I choose?
Choosing the compression level depends on the patient’s specific needs:
• 15-20 mmHg: Best for everyday wear, mild swelling, and fatigue due to long periods of sitting or standing. Ideal for travel.
• 20-30 mmHg: The first medical-grade compression, suitable for managing moderate swelling, spider veins, varicose veins, and post-surgery recovery. Popular among pregnant women for alleviating leg discomfort.
• 30-40 mmHg: Recommended for moderate to severe symptoms, such as lymphedema and deep vein thrombosis. Requires consultation with a healthcare professional due to its strength.
• 40-50 mmHg: Very strong compression for severe conditions like venous stasis and wound management. Consult your doctor before use.
Contact Us
• Phone: (805) 782-9300
• Fax: (805) 782-9700
• Email: orders@cclymph.com