Order Forms
For Prescribers
If you would like to use our prescription form, please print, complete, and fax to us directly at (636) 489-1564 or email to neworders@gatewaymedical.net. We will take care of contacting the patient.
For Self-Referral
If you are interested in a brace for yourself, please complete the printable form below. We will contact you for a phone consultation before contacting your provider.