I could not post a copy of the form for a medicare claim, but I am trying o do the next best thing. Here is a link to where you can download the forms for yourself. http://www.cms.gov/CMSForms/CMSForms/itemdetail.asp?filterType=dual,%20keyword&filterValue=1490S&filterByDID=0&sortByDID=1&sortOrder=ascending&itemID=CMS012949&intNumPerPage=10
Click on the link called CMS "1490S-ENGLISH" under the downloads section and you have no problem getting the form yourself. Good Luck filing your cliaim.
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