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Insurance Forms


We are authorized provider of durable medical equipment for most insurance plans including Blue Cross & Blue Shield, Fallon Community Health Plan, Tufts Health Plan, Harvard Pilgim, Cigna, United Healthcare, Medicare, and many others.

We handle all insurance billing so you don't have to.

In order to process your order and bill your insurance company, we are required to have completed insurance forms on file. The most common forms are listed below. After you place your order on this website, a member of our experienced staff will contact you to confirm your order and begin processing your insurance claim. We will tell you which forms need to be completed. You can then download the needed forms below, print them out, fill in the required information and return them by fax (978-534-3112) or mail (William Allen Co., 26 Main Street, Leominster, MA 01453).

HCFA 1500 Form

DME Upgrade Form

Proof of Delivery Form
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