*We do not require a copy of your prescription for replacement parts, headgear, filters, cleaning supplies or other products that do not have the "prescription required" notice on their product page.*
After you submit your valid precription you can place your order online. If there are any problems with the prescription that you submitted we will contact you immediately. Thank you!
Before you send us your prescription please be sure that it meets the following requirements:
The prescription is written by one of the following care providers:
Doctor of Osteopathy
Dentist / Orthodontist
The prescription must include:
Your name (patient's name)
Prescribing physician's full name
Physicians Contact Information
Your prescription can be written on a standard prescription pad which includes the physician's contact information, your full name and is signed by the care provider including a statement about the equipment needed.
- "CPAP" or “Continuous Positive Airway Pressure”
- “APAP”, “AutoPAP” or similar
- "BiPAP", BiLevel” or similar
- "CPAP Supplies"
- "CPAP Mask"
- "CPAP Heated Humidifier"
Fax to (866) 649-2727 and a representative will call you to confirm receipt.
Email to firstname.lastname@example.org Please include full name and phone number
SUBMIT FILE DIRECTLY