Prescription Request Form
Prescriptions
Federal law requires we have a valid prescription on file before shipping a mask, machine & humidifier.
Please submit a prescription with a future expiration date, written for “lifetime need”, or “99 months”.
As long as the prescription has these prerequisites, you can purchase CPAP equipment.
If you are making the purchase of a prescription-required item without insurance, we still need a prescription to fulfill the order based on Federal regulations.
CPAP Accessories and mask parts are the only equipment sold without without a prescription.