Milk Storage Bag and Breast Pump Replacement Parts Resupply

By checking this box, I understand that I am authorizing Neb Medical Services to supply me with Milk Storage Bags and/or Breast Pump Resupply parts and I authorize Neb Medical Services to bill my insurance. I understand that I will be responsible for insurance cost sharing including copay and deductible. Further, I understand that opened/used equipment cannot be returned due to infection control purposes.