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Referral name, address and phone: Web if you have received this document in error, please notify us immediately by telephone and return the original via the us postal. Web diabetes supplies order form. Send completed form, demographics sheet, plus copy of front and back of insurance card(s). Web how do i place an order? Web byram offers many ordering options including through our website, mobile app, text, and email. Log into mybyram and click on place order. follow the prompts provided. } required information q face sheet attached. Enroll now to easily place reorders online, view your. Referral name, address and phone: