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Assignment Requests


Assignment requests can be submitted to L.T.D. America Total Care, Inc. in two (2) ways.

  • Entered and submitted on-line.
  • Via a downloadable form to be filled later and sent as an attachment to an
    e-mail. This method is for those who prefer to print a hard copy of the forms and fax or mail them.

In either case, separate “assignment” forms are available for each service we provide: (some are currently being reviewed and have no link available).

Downloadable to be
Mailed or Faxed

On-line Filled and
Submitted from this site

Transportation

Transportation

In-Person Interpretation

In-Person Interpretation

Diagnostic Scheduling

Diagnostic Scheduling

Durable Medical Equipment

Durable Medical Equipment

Home Health

Home Health

 

L.T.D. America Total Care, Inc.©
P. O. Box 970098, Boca Raton, Florida 33497-0098
Phone: 877-605-0005              Fax: 561-353-1140
info@ltdamerica.com

All information on this Web site is copyright of 
©L.T.D. America Total Care, Inc.. 2005-2008.