A prescription from a physician is required to obtain a Select device.
Use this information to help you investigate if Select is right for you.
Letter of Medical Necessity form (LOMN)
A LOMN is a letter provided by your physician that indicates a service or supply is appropriate and necessary for your medical condition. If the device is appropriate, your physician will fill out this LOMN form and submit it to Empi Recovery Sciences, the manufacturer of Select Pain Control.
Follow these easy steps:
1.)
Download a LOMN form (44 KB)
2.) Bring this form to your physician and request an evaluation for the use of Select Pain Control. If the device is appropriate, the LOMN form should be completed and submitted by your clinic.
Assess Your Pain
In order to facilitate the conversation with your doctor regarding the Select, please take the short questionnaire.
Take the questionnaire now
