Letter of Medical Necessity (LOMN)

If your patients is sensitive to chemicals and a non smoker, you can request that we construct a mattress without the flame retardant materials. We need a Letter of Medical Necessity. Use the sample letter below, put it on your letterhead, and sign the letter. Send it to us via email to tjwilliams@bioposture.com or Fax it to 516.706.8182.




(Date)

BioPosture
218 E. Park Avenue
606 Long Beach, NY
11561

To Whom It May Concern:

My patient (name) is extremely allergic and sensitive to the chemical components in standard mattresses.  Accordingly, we require a mattress without the mandated fire retardant treatment.

 

Sincerely,

(DC signature)

 

 

 

THE DOCTOR RECOMMENDED MATTRESS FOR BACK PAIN, ORTHOPEDIC SUPPORT AND UNMATCHED COMFORT!