Download this Medical Insurance Claim Statement Form to help ease the process of obtaining reimbursement from a U.S. health insurance organization for the purchase of a home-use iontophoresis machine (for the treatment of sweaty hands or feet) from the U.S. manufacturer R.A. Fischer Company. This form should be completed and submitted to the appropriate health insurance organization by your treating physician. You can help your doctor by printing the form and taking it to your next appointment.
Iontophoresis is a learned technique. Ideally, you perform the technique at home using your own iontophoresis machine after detailed training and practice under a physician’s supervision.