Instructions for Applying with Private Insurance
Click here to access the Private Insurance Application. Please complete the application online, then print off to include your signature. 
Request a prescription from your doctor. If you are unable to visit your doctor to obtain a prescription, please include your doctor’s name, address and phone number on the Private Insurance Application and we will work with your doctor to obtain your prescription – which saves you a doctor’s visit!
Send your signed completed application to Bonro Medical®. Remember to include your doctor’s prescription or contact information. After receiving your application we will handle the rest!
3 Ways to Submit Your Application:
Fax Your Application To:
706-210-4740
706-210-4740
Mail Your Application To:
Bonro Medical
P.O. Box 1880
Evans, GA 30809
Bonro Medical
P.O. Box 1880
Evans, GA 30809
If You Have a Scanner
Email Your Completed Application to info@bonro.com!
*You will need to scan in your signed completed application and the front & back of your insurance cards.
Email Your Completed Application to info@bonro.com!
*You will need to scan in your signed completed application and the front & back of your insurance cards.
Questions?
Give us a call and we’ll be happy to answer any questions you may have!
1-877-266-7699 Toll-Free • 706-210-4747 Local
