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Get the free ACCENT DEVICE/ACCESSORY SELECTION SHEET

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Saltillo 1022 Hal Road | Wooster, OH 44691 Phone 800.262.1984 | Fax 330.263.4829 Saltillo.component DEVICE/ACCESSORY SELECTION SHEET CLIENT: The client is the person who will be receiving the equipment
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How to fill out accent deviceaccessory selection sheet

01
Make sure you have the accent deviceaccessory selection sheet in front of you.
02
Fill out your personal information such as name, contact information, and date.
03
Look at the list of available accessories and check the box next to the ones you want to order.
04
If there are any specific notes or preferences, make sure to write them down in the designated area.
05
Review the completed form to ensure all information is accurate before submitting.

Who needs accent deviceaccessory selection sheet?

01
Individuals who are interested in purchasing accessories for their accent device.
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The accent device/accessory selection sheet is a document used to select the appropriate accessories for an accent device.
The healthcare provider or prescriber is required to file the accent device/accessory selection sheet.
To fill out the accent device/accessory selection sheet, the healthcare provider or prescriber must provide information about the patient, the device, and select the appropriate accessories.
The purpose of the accent device/accessory selection sheet is to ensure that the correct accessories are selected for an accent device to meet the patient's needs.
The accent device/accessory selection sheet must include information about the patient, the device being used, and the selected accessories.
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