Please fill out the form below to being the process of insurance submission for your prescribed products. To finalize the submission, our staff needs the following to complete your order and submit your CPAP machine, masks and supplies to your Insurance Company.
A copy of your Insurance Card
A copy of your doctor’s prescription for your CPAP machine, mask and/or supplies.
A copy of your Sleep Study Dictation
A copy of last progress report from your prescribing doctor.
After you complete the form below, you can email or fax the above items to:
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