Applicants must provide the following to qualify for services:
Copy of original prescription
Government issued photo ID
Proof of Dallas County residence
Proof of financial need, must be 200% below federal poverty level (bank statement, paystub, ss award letter or a letter from a referring social worker verifying the client is unable to pay is acceptable)
Uninsured, gap coverage (decline letter)
Completed DME Exchange Intake Form
Please fax items to 888-235-3639
(Proof of Parkland Health Plus coverage satisfies the residence and financial qualifications**)
Types of Equipment:
Manual wheelchairs
Sliding and rolling walkers
Crutches and canes
Shower chairs
Bedside commodes
Tub transfer benches
Commodes, elevated toilet seats
Patient lifts
Application Form | intake form.pdf | 10-18-2023 |
Misc Attachment | DME release of info.pdf | 10-18-2023 |
Misc Attachment | DME checklist.pdf | 10-18-2023 |