Referrals

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Urological Referral
Incontinence Referral
Ostomy Referral

These forms are for healthcare professionals to refer patients to Active Life Medical Products. Thank you for choosing us to help your patients with their catheter, incontinence, and ostomy needs.

 

  • Accreditation by the Board of Certification (BOC).
  • 25+ years supplying catheters, incontinence, and ostomy supplies.
  • Exceptional service provided by our Product Specialists.
  • Insurance companies are directly contacted for product approvals.
  • Free product samples are offered to help you find the right product.

CONTACT US

CALL NOW<br> (800) 319-2336
Email Us<br>support@activelifemed.com
FAX<br> 209-926-9231
CALL NOW <br>(800) 319-2336
Email Us<br>referrals@activelifemed.com
FAX<br> 209-926-9231