Forms Built to Capture CGM Patient Leads for VitalWave in Cherry Hill, NJ

vitalwavemedsupplies.com

VitalWave Medical LLC is a Cherry Hill, New Jersey medical supply company helping Medicare-eligible patients access free or low-cost Continuous Glucose Monitoring (CGM) devices — like the FreeStyle Libre 3 and Dexcom G7 — through Medicare or their private insurance. Many of their patients are Type 1 or Type 2 diabetics who take insulin and don’t yet realize they may already qualify.

We built VitalWave a lead-generation-focused WordPress website centered on one goal: getting visitors to check their CGM eligibility. Pages like their New Jersey CGM Medicare Eligibility page pair clear, benefit-focused copy with an eligibility form and order form, so a patient — or their caregiver — can find out if they qualify and get supplies moving in minutes.

Vitalwave Medical CGM Medicare eligibility landing page featuring navigation menu, hero section with woman, and call-to-action buttons.
Continuous glucose monitoring webpage with hero image of people preparing healthy food and a green eligibility CTA button.
Vitalwave Medical eligibility check form with navigation menu, diabetes monitoring imagery, and patient information input fields.
VitalWave CGM order form with patient information, insurance details, and supplies section
Medical order form with phone/fax fields, file upload area, physician signature field, and date inputs for patient documentation submission.
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Fluid Web Design

Responsive

A fully responsive layout that adapts to any screen, so patients can check their CGM eligibility just as easily from a phone as from a desktop.

VitalWave Medical responsive website design showing mobile, tablet, and desktop layouts for diabetes and CGM Medicare eligibility services.

Custom Sign Up Forms

Purpose-built forms — like the file upload step on the CGM Rx form — make it easy for patients to submit prescriptions and insurance info in one visit.

File upload field for Vitalwave CGM order form with drag-and-drop zone and upload button

eSignatures

Built-in eSignature capture lets patients sign off on required paperwork right in the form — no printing, scanning, or faxing needed.

Vitalwave CGM order form esignature field with required provider signature input box displaying sample handwritten signature

Automated PDF Delivery

Every eligibility and order form submission is automatically converted into a clean, ready-to-send PDF with Gravity PDF — so VitalWave can forward a patient’s completed paperwork straight to their supplier or Medicare without retyping a single field.

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Website Security

Protect

Every page runs over a valid SSL certificate, encrypting the connection so patient information entered anywhere on the site stays private in transit.

SSL padlock and HTTPS protocol symbol overlaid on blue digital code background representing secure encryption.

Login Protection

The WordPress admin login lives at a custom, non-default URL, keeping automated bots and brute-force login attempts away from the site.

Loginizer WordPress plugin settings for customizing login URL slug and access control options.

Safe Data Collection

Form entries are automatically purged after a set retention period, limiting how long sensitive patient submissions are stored on the site.

Gravity Forms retention policy settings panel with radio button options for entry retention and a 30-day field configuration.

Stack Media Design Client Reviews

4.9
32 Google reviews
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Annmarie

Jessie and stack media design have completely changed how people find us online. We had him build out local SEO landing pages for our business to target towns around us and nearby. I honestly wasn't sure it would make much of a difference - but we're now averaging about 200 more clicks to our website every month than we were before. As someone who runs a small nursery and isn't exactly "techy," I really appreciated that he explained everything in plain English and never made me feel silly for asking questions. He's responsive, patient, and clearly knows what he's doing when it comes to seo and getting a local business found on Google. If you have a small business and want to actually show up when people search for what you do, stack media is who you call.

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Iqbal Ahmed

Stack Media was great to work with. Jesse takes his time to understand what is expected in the final product. Very easy to communicate and make recommendation to the website building process. He completed the projected in the time frame we had initially discussed. Overall stack media is great value, quality product and very easy to work with!!!

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Diane Portantiere

Diane Portantiere

Love working with Jesse at Stack Media - very responsive and strives to make the customer happy!

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Jesse is one of the most talented web designers in the space for the looking to have a clean, modern look to their website. He also included SEO for me, all together which cost me a fraction of what others were offering.

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Dave Yorke

Dave Yorke

Found Jesse’s ad on Craigslist and I have referred him to people already. He is right on top of everything. I had no idea what I wanted and he walked me though the whole process. Very approachable and understands what you want even if you don’t. I highly recommend his services.

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April Litty

We needed a new website for our south new jersey union branch website that was created back in 1997. After one of our union members who managed the website retired, we desperately needed a more modern and user friendly website moving forward because our current website was so outdated. Stack Media Design & Jesse did an amazing job. They understood the situation and built a new website from scratch on the free wordpress platform which is so easy for us to manage the monthly newsletters & events. Jesse showed us everything & within minutes we were easily able to start managing our website. Thank you so much Jesse & stack media for the great job you did!

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Stephen Santry

I was looking for web page designers near Cherry Hill, NJ and a friend of mine recommended Stack Media Design. I gave them a call and spoke with Jesse about getting a website created for my new business. He was very helpful, took the time to understand and point me in the right direction. The price was very affordable and website came out great! He took care of everything including getting my website up and running. Also I am saving a lot of money using his website hosting services. On top of all of that he has been a resource for any questions I have well after the website was constructed. He has been with me every step of the way to this day if I am looking for some advice. Anyone looking for a new business website, I highly recommend Jesse & Stack Media Design!

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Golden Route

Golden Route

Stack Media Design has performed excellent for our businesses! We have used their web design services for multiple projects with great success. Our businesses generate tens of thousands of dollars every month online through our websites, so it is crucial that we have a reliable web design company like Stack Media Design in our corner. They are local right here in New Jersey which is nice. They are dependable and the owner Jesse always has time for me and my staff to go over tasks that are needed for our websites. We also have our websites hosted with Stack Media Design. We switched from HostGator a few years ago and have been very happy since. We now pay significantly less each year since we switched. Also we've noticed our websites load more reliable and faster. Thank you so much Stack Media Design! I highly recommend them for web design, hosting, and all the services they offer!

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Cathleen McGuire

Cathleen McGuire

As a Content Strategist, I give Stack Media and Jesse Lange my highest recommendation. I needed technical help for a website I was building from scratch for a client using WordPress. I know HTML, but I never could have done this project without Jesse. He is very proficient technically and not just for programming. He was excellent with all manner of gnarly web productions issues like optimizing photos, wrangling with forms and notifications, and finetuning the visual design and user experience. Most of all, Jesse was there for me! On several occasions, out-of-the-blue problems arose and he did not leave me hanging. He stayed with it until the problem was fixed, including if it took several days, even interfacing with Microsoft and the ISP when the going got tough. Whenthe experts couldn't even figure things out, it was Jesse who came up with innovative solutions to resolve the issues. I trust him completely -- technically, professionally, and just as a great person. He's respectful, conscientious, and truly wants to see you succeed. Jesse Lange is THE BEST!!

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Anthony DeLaurentis

Very professional website design. I am not very tech savvy and the owner worked with me throughout the process and couldn't have been more helpful. Highly recommend.

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More websites we built that are vital to our clients

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(732) 608-1230