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Home > 5% Cash Back

5% Cash Back

Welcome to Western Diabetic’s Rewards Program

Thanks for taking the time to visit our website. We are confident that Western Diabetic is one of the most competitively priced diabetic and medical supply websites. As you browse through our website you will notice a wide variety of products as well as low prices. In addition to the everyday low prices Western Diabetic a rewards program.

With our rewards program, you receive one point for every dollar you spend with us. At any point you can redeem you points for almost everything on our website. By receiving your rewards points, not only are you paying low prices for things that need to be purchased on a regular basis, but you are also accumulating points to be able to receive those same products you buy for free. So basically, as a customer you are saving on both ends. You are saving money on the front end with your everyday purchases, and with your points you can get products for free. It makes sense, so why not take advantage.

The best part is that you do not have to do anything to start receiving your points; you automatically start accruing your points with the very first purchase. Additionally, Western Diabetic offers a convenient tool for you to always have the supplies you need. Through auto ship, Western Diabetic securely stores your credit card information and ships to you regularly given your specifications (Should you choose to use the feature).

Please Fill out the following or place an order to start SAVING money!

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Patient Information
First Name:	*
Last Name:	*
Address:	*
Address 2:
City:	*
State:	*
Zip Code:	*
Home Phone:	*
Alternate Phone:
Date of Birth:	*
Email:	*

Insurance Information
Insurance Plan:	*
Insurance ID Number:	*
Insurance Phone Number (if not medicare):

Physician Information
Physician Name:	*
Physician Phone:	*
Physician Fax:

I'm interested in: (check boxes that apply)

Diabetes Testing Supplies
Insulin Pump Supplies/Syringes
Intermittent Urinary Catheters
Lower Back Pain Relief
Other (specify)

Additional Comments:

By submitting this form, I authorize Western Diabetic Supplies to contact me and my physician regarding the provision of supplies. This information is to be used only for this purpose.

* deductibles and co-insurance may apply

This site is for informational purposes only and is not intended as a substitute for advice from your own physician or other health professional. You should not use the information contained on this site for diagnosing or treating a health problem or disease, or prescribing any medication. You should read carefully all product packaging. You should consult with a healthcare professional before starting any diet, exercise or supplementation program, before taking any medication, or if you have or suspect you might have a health problem. Information and statements regarding dietary supplements have not been evaluated by the Food and Drug Administration and are not intended to diagnose, treat, cure, or prevent any disease. Prices and promotions are subject to change without notice.