ccsmed.com
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Submitted URL: https://www.ccsmed.com/contact-us
Effective URL: https://ccsmed.com/contact-us/
Submission: On June 10 via api from US — Scanned from DE
Effective URL: https://ccsmed.com/contact-us/
Submission: On June 10 via api from US — Scanned from DE
Form analysis 2 forms found in the DOM
GET https://ccsmed.com
<form role="search" method="get" id="searchForm" class="search-desktop-form flex-auto w-full h-full" action="https://ccsmed.com">
<div class="flex h-full">
<label class="sr-only" for="s">Search for:</label>
<input class="bg-gray-50 w-full" type="text" value="" name="s" id="s">
<input id="searchsubmit" class="search-desktop-real-submit rounded-l-none bg-blue font-medium bg-[url('../components/atoms/arrow-right-white.svg')] lg:text-white lg:min-w-[168px]" type="submit" value="Search">
</div>
</form>POST /contact-us/
<form method="post" enctype="multipart/form-data" id="gform_4" action="/contact-us/" data-formid="4" novalidate="">
<div class="gform-body gform_body">
<div id="gform_fields_4" class="gform_fields top_label form_sublabel_below description_below">
<div id="field_4_1" class="gfield gfield--type-text gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible" data-js-reload="field_4_1"><label
class="gfield_label gform-field-label" for="input_4_1">Name<span class="gfield_required"><span class="gfield_required gfield_required_text">(Required)</span></span></label>
<div class="ginput_container ginput_container_text"><input name="input_1" id="input_4_1" type="text" value="" class="large" aria-required="true" aria-invalid="false"> </div>
</div>
<div id="field_4_11" class="gfield gfield--type-text gfield--width-half field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible" data-js-reload="field_4_11"><label class="gfield_label gform-field-label"
for="input_4_11">Title</label>
<div class="ginput_container ginput_container_text"><input name="input_11" id="input_4_11" type="text" value="" class="large" aria-invalid="false"> </div>
</div>
<div id="field_4_4" class="gfield gfield--type-text gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible" data-js-reload="field_4_4"><label
class="gfield_label gform-field-label" for="input_4_4">Phone<span class="gfield_required"><span class="gfield_required gfield_required_text">(Required)</span></span></label>
<div class="ginput_container ginput_container_text"><input name="input_4" id="input_4_4" type="text" value="" class="large" aria-required="true" aria-invalid="false"> </div>
</div>
<div id="field_4_3" class="gfield gfield--type-text gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible" data-js-reload="field_4_3"><label
class="gfield_label gform-field-label" for="input_4_3">Email<span class="gfield_required"><span class="gfield_required gfield_required_text">(Required)</span></span></label>
<div class="ginput_container ginput_container_text"><input name="input_3" id="input_4_3" type="text" value="" class="large" aria-required="true" aria-invalid="false"> </div>
</div>
<div id="field_4_12" class="gfield gfield--type-text gfield--width-full field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible" data-js-reload="field_4_12"><label class="gfield_label gform-field-label"
for="input_4_12">Company</label>
<div class="ginput_container ginput_container_text"><input name="input_12" id="input_4_12" type="text" value="" class="large" aria-invalid="false"> </div>
</div>
<fieldset id="field_4_13" class="gfield gfield--type-address gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible" data-js-reload="field_4_13">
<legend class="gfield_label gform-field-label gfield_label_before_complex">State<span class="gfield_required"><span class="gfield_required gfield_required_text">(Required)</span></span></legend>
<div class="ginput_complex ginput_container has_state ginput_container_address gform-grid-row" id="input_4_13">
<span class="ginput_right address_state ginput_address_state gform-grid-col" id="input_4_13_4_container">
<select name="input_13.4" id="input_4_13_4" aria-required="true">
<option value="" selected="selected"></option>
<option value="Alabama">Alabama</option>
<option value="Alaska">Alaska</option>
<option value="American Samoa">American Samoa</option>
<option value="Arizona">Arizona</option>
<option value="Arkansas">Arkansas</option>
<option value="California">California</option>
<option value="Colorado">Colorado</option>
<option value="Connecticut">Connecticut</option>
<option value="Delaware">Delaware</option>
<option value="District of Columbia">District of Columbia</option>
<option value="Florida">Florida</option>
<option value="Georgia">Georgia</option>
<option value="Guam">Guam</option>
<option value="Hawaii">Hawaii</option>
<option value="Idaho">Idaho</option>
<option value="Illinois">Illinois</option>
<option value="Indiana">Indiana</option>
<option value="Iowa">Iowa</option>
<option value="Kansas">Kansas</option>
<option value="Kentucky">Kentucky</option>
<option value="Louisiana">Louisiana</option>
<option value="Maine">Maine</option>
<option value="Maryland">Maryland</option>
<option value="Massachusetts">Massachusetts</option>
<option value="Michigan">Michigan</option>
<option value="Minnesota">Minnesota</option>
<option value="Mississippi">Mississippi</option>
<option value="Missouri">Missouri</option>
<option value="Montana">Montana</option>
<option value="Nebraska">Nebraska</option>
<option value="Nevada">Nevada</option>
<option value="New Hampshire">New Hampshire</option>
<option value="New Jersey">New Jersey</option>
<option value="New Mexico">New Mexico</option>
<option value="New York">New York</option>
<option value="North Carolina">North Carolina</option>
<option value="North Dakota">North Dakota</option>
<option value="Northern Mariana Islands">Northern Mariana Islands</option>
<option value="Ohio">Ohio</option>
<option value="Oklahoma">Oklahoma</option>
<option value="Oregon">Oregon</option>
<option value="Pennsylvania">Pennsylvania</option>
<option value="Puerto Rico">Puerto Rico</option>
<option value="Rhode Island">Rhode Island</option>
<option value="South Carolina">South Carolina</option>
<option value="South Dakota">South Dakota</option>
<option value="Tennessee">Tennessee</option>
<option value="Texas">Texas</option>
<option value="Utah">Utah</option>
<option value="U.S. Virgin Islands">U.S. Virgin Islands</option>
<option value="Vermont">Vermont</option>
<option value="Virginia">Virginia</option>
<option value="Washington">Washington</option>
<option value="West Virginia">West Virginia</option>
<option value="Wisconsin">Wisconsin</option>
<option value="Wyoming">Wyoming</option>
<option value="Armed Forces Americas">Armed Forces Americas</option>
<option value="Armed Forces Europe">Armed Forces Europe</option>
<option value="Armed Forces Pacific">Armed Forces Pacific</option>
</select>
<label for="input_4_13_4" id="input_4_13_4_label" class="gform-field-label gform-field-label--type-sub ">State</label>
</span><input type="hidden" class="gform_hidden" name="input_13.6" id="input_4_13_6" value="United States">
<div class="gf_clear gf_clear_complex"></div>
</div>
</fieldset>
</div>
</div>
<div class="gform_footer top_label"> <input type="submit" id="gform_submit_button_4" class="gform_button button" value="Submit"
onclick="if(window["gf_submitting_4"]){return false;} if( !jQuery("#gform_4")[0].checkValidity || jQuery("#gform_4")[0].checkValidity()){window["gf_submitting_4"]=true;} "
onkeypress="if( event.keyCode == 13 ){ if(window["gf_submitting_4"]){return false;} if( !jQuery("#gform_4")[0].checkValidity || jQuery("#gform_4")[0].checkValidity()){window["gf_submitting_4"]=true;} jQuery("#gform_4").trigger("submit",[true]); }">
<input type="hidden" class="gform_hidden" name="is_submit_4" value="1">
<input type="hidden" class="gform_hidden" name="gform_submit" value="4">
<input type="hidden" class="gform_hidden" name="gform_unique_id" value="">
<input type="hidden" class="gform_hidden" name="state_4" value="WyJbXSIsIjQ2N2YxMTE2NTRlOGJmNDQ3MTczYzljZDZkMDRlMGQwIl0=">
<input type="hidden" class="gform_hidden" name="gform_target_page_number_4" id="gform_target_page_number_4" value="0">
<input type="hidden" class="gform_hidden" name="gform_source_page_number_4" id="gform_source_page_number_4" value="1">
<input type="hidden" name="gform_field_values" value="">
</div>
</form>Text Content
Skip to content * * New Patient Patient Portal CCS Medical Get Started * Why CCS * What to Expect * Insurance Coverage * Products We Cover * FAQ * Enroll as a New Patient Customer Resources * MyCCSMed * Reorder Supplies * Support Organizations * Education LivingConnected® Clinical Solution For Partners * Providers * Health Plans * Employers & IDNs * Manufacturers Reorder Search for: suggested Recent Searches Popular Products Get Started Get Started * Why CCS * What to Expect * Insurance Coverage * Products We Cover * FAQ * Enroll as a New Patient Customer Resources Customer Resources * MyCCSMed * Reorder Supplies * Support Organizations * Education LivingConnected® Clinical Solution LivingConnected® Clinical Solution For Partners For Partners * Providers * Health Plans * Employers & IDNs * Manufacturers New Patient Patient Portal Language: * * Reorder CONTACT US Need assistance? We’re here to help! Our customer support specialists are knowledgeable and eager to answer your questions. SEND US AN EMAIL help@ccsmed.com GIVE US A CALL 1.888.MEDICAL (1.888.633.4225) Hours of Operation: 9 a.m. - 6 p.m. ET, Monday - Friday SPECIALIST CONTACT Diabetes 1.888.633.4225 LivingConnected® 1.800.966.2046 Pharmacy 1.888.308.8882 Ostomy/Urology 1.800.722.2604 Wound Care 1.800.690.1255 CONTACT US Name(Required) Title Phone(Required) Email(Required) Company State(Required) AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State OUR LOCATIONS CORPORATE HEADQUARTERS 3030 LBJ Fwy Suite 1525 Dallas, TX 75234-7758 972.628.2100 PATIENT CORRESPONDENCE CCS Medical PO Box 17753 Clearwater, FL 33762-0753 View our other Locations ANAHEIM, CALIFORNIA 5464 E. LaPalma Ave. Unit B Anaheim, CA 92807 CLEARWATER, FLORIDA 14255 49th St. North Suite 301 Clearwater, FL 33762 KNOXVILLE, TENNESSEE 9111 Cross Park Drive Suites 271 and D275 Knoxville, TN 37923 ARLINGTON, TEXAS 3939 W. Green Oaks Blvd. Suite 205 Arlington, TX 76016 DALLAS, TEXAS 3030 LBJ Fwy Suite 1530 Dallas, TX 75234 PITTSBURGH, PENNSYLVANIA 10475 Perry Hwy. Suite G102 Wexford, PA 15090 ATLANTA, GEORGIA 3505 Koger Blvd. Suite 220 Duluth, GA 30096 DENVER, COLORADO 6655 W. Jewell Suites 206, 212 and 218 Lakewood, CO 80232 ROANOKE, VIRGINIA 3601 Thirlane Road NW Suite 4 Roanoke, VA 24019 CHARLOTTE, NORTH CAROLINA 4108 Park Rd. Suite 320 Charlotte, NC 28209 ST. PETERSBURG, FLORIDA 160 Fountain Pkwy N Suite 200 St. Petersburg, FL 33716-1205 INTERESTED IN ORDERING PRODUCTS FROM CCS? SEE HOW EASY IT IS. Learn More Corporate Headquarters 3030 LBJ Fwy Suite 1525 Dallas, TX 75234-7758 1.888.MEDICAL help@ccsmed.com COMPANY * About * Leadership * Newsroom * Careers * Contact Us RESOURCES * New Customers * Reorder Supplies * Insurance Coverage * Products We Cover * FAQ * Support Organizations * Education PARTNERS * Providers * Health Plans * Employers & IDNs * Manufacturers * Parachute Health SOLUTIONS * LivingConnected® * LivingConnected® with Gestational Diabetes * LivingLinked™ LEGAL * Supplier Standards * Accessibility Statement * Debt Exchange Disclosure * Equity Exchange Disclosure * Terms of Service * Privacy Practices Notifications