Use this form to request new supplies.
Please be aware that CPAP equipment requires a written prescription from the physician.
The doctors will not write prescriptions unless you are current with your appointments.
If you have not seen our doctor in the last 12 months please call and make an appointment.
You may be able to get your new supplies or a prescription for them at that same appointment.
Availability of CPAP supplies is dependent upon current insurance authorizations and you may be responsible for deductibles or co-payments mandated by your insurance plan.
** We now offer an automatic 90 day re-supply program with free shipping. Check the appropriate box in the form below to get more information or to be automatically enrolled in the program. **