Welcome to Community Healthcare Access Discount Medical Products • At-Home Lab Testing Pharmacy Home Delivery • Audiology Testing and Hearing Aids Vision Screening and Assistance with Medicare™ and Medicaid™ Issues "Providing an Easy and Affordable Continuum of Healthcare Directly to your Home" Patient Name: Contact Person (If different than the patient) Patient Name: Address: City: State / Zip: Telephone Number     Insurance Type:     Medicare   Medicaid     Private Insurance   Private Pay         Other     Insurance Information: Company Name: Telephone Number: Policy Number: Agent Name / Code:     Patient Type:       Geriatric   Mentally Ill (MI)     Disabled         Placement Services:     Assisted Living   Nursing Home     Homeless         Pharmacy Prescriptions: Rx # Medication: Rx # Medication: Rx # Medication: Rx # Medication: Rx # Medication:     Doctor's Office Information: Doctor's Office: Telephone Number: Address: City: State / Zip:     Location Type:       Senior Building   Hospice     Church   Practice     At-Home Mobility Devices:     Power Chair   Scooter     Walker   Cane     Hospital Bed   Oxygen Portable     Seat Lift   Barton Bed Lift     Free Medical Consultation   Medical Transportation to Clinic     At-home Diabetic Supplies:     Diabetic Meter   Lancets     Diabetic Shoes   Strips     Diabetic Socks         Full Service Lab Testing Anywhere in the USA On-Demand: Name Your Lab Test: How soon do you need it done? Date: What State?     Would you like informative free information on that test?   Yes   No Would you like to ask our lab director any questions about a test?   Yes   No     At-Home Point-of-care Lab Testing Order:     Cholesterol   Pro-Time     DNA Testing   Drug Testing     Discount Medical Supplies:     Diapers   Latex gloves     Heating Pads   Blood Pressure Cuff     Hot / Cold packs   First Aid Kit     Onsite Service Screenings:     Home care nursing   Home care doctor     Hospice Care   Hearing Screens     At-Home   Vision Screens         Pharmacy     Please enter any special needs of a patient below:     If you have any questions for products or services not listed, contact us through this comment box. Quick Links Discount Medical Products Lab Testing at Home DNA Testing Medical Lab Testing anywhere in USA Seniors At-home Pro-Time Testing At-home Medical Supplies and Point-of-Care Testing Laboratory Testing in Your Home DNA Testing for Paternity and Forensic Testing Discounted Medical Supplies Delivered to Your Home Home care Products Billed to Medicare and Private Insurance Home care Nursing and Physician visits in Certain Areas. Nursing Home Assisted Living Placements in certain areas. Home Delivery Pharmacy Charity auction site link to help people in need. Lab Testing anywhere in the USA Point-of-care Laboratory Testing Cholesterol Testing Drug Testing Hbaic 1,000s of Medical Supplies Latex Gloves Blood Pressure Cuff Adult Diapers Hospital Beds Gel Cushions Medicare Paying in Full Product Categories At Home Diabetic Supplies Full Service Lab Testing DNA Testing On Demand Discount Medical Supplies At-Home Mobility Devices At Home Point-Of-Care Lab Testing     Special Discount for first-time orders! Receive 10% on any diabetic supply or blood pressure cuff. 10% OFF any DNA Testing Call us for a free phone consultation to review your healthcare needs. For All Your Healthcare Needs. All of us At Community Healthcare Access Toll Free 24-Hour Access: 1-800-557-4875         Locations and Phone Contacts:   Direct Healthcare Access 350 West Kensington Road Mount Prospect, IL Phone: (847) 222-9546 CHA of Chicago 4944 West Huron Chicago, IL Phone: (773) 379-6983 CHA of Milwaukee 2603 Dr. Martin Luther King Drive Milwaukee, WI Phone: (414) 263-8352