FORMS
Order Form
Please complete the form below. If you need help, call (801) 841-4490.
Signed proof of delivery is now required
Effective October 10, 2026, the Department of Labor’s DEEOIC program requires signed proof of delivery for durable medical equipment (DME), including delivery and setup.
The patient must sign, or a representative, the patient’s spouse, or another family member age 18 or older may sign on the patient’s behalf. A nurse or case manager may also sign.
Once the item is delivered, EWMS can send the proof of delivery form by text or email to the preferred eligible signer.
Proof of Delivery Contact Preference (individual and contact method):
Please provide EWMS with the eligible signer’s name, relationship to the patient, preferred contact method (text or email), and mobile number or email address. If your online form does not include these fields, call (801) 841-4490 to share your preference.