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Contact

Patient Referral Form

Please Complete the form below and our team will handle the rest

Provider Information

Patient Information

Date of Birth
Month
Day
Year
Preferred Contact Method
Equipment/Services Needed

Your health information is always protected

Diabetes Supplies Supplier - DiaHealth Solutions

Contact

153 Narrows Parkway

Suite 103

Birmingham, AL 35242

P: (205) 453-7599

F: (205) 882-5557

contact@diahealthsolutions.com

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Brands 

Beta Bionics

Dexcom

Libre

Omnipod

Medtronic

Tandem

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About DHS

About Us

How To Order

Our Solutions

Insights

Medicare Supplier Standards

Notice of Privacy Practices

Careers

Diabetes Awareness Company

HIPAA Compliance and Privacy Notice
DiaHealth Solutions is fully committed to protecting the privacy and security of all personal and protected health information (PHI) in accordance with the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and all applicable federal and state privacy laws. All information collected by DiaHealth Solutions is used solely for the purpose of providing medical equipment and related services to our patients.

DiaHealth Solutions will not sell, disclose, or release any personal or protected health information to any unauthorized third party under any circumstances, except as required or permitted by law, or with the individual’s explicit written authorization.

DiaHealth Solutions, LLC all rights reserved
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