CPAP supplies

Fill out the form below to start the order process.  If more information is required, an American HomePatient customer service agent will contact you within two business days. Or call 877-221-8763.


  • Fields with an * indicate required information.

  • *
  • *
  • *
  • *
  • *
  • *
  • *
    ex. 555-555-5555
  • *

  • American HomePatient Location

    If applicable, please provide the city and state of the American HomePatient location
    currently serving you:


Recommended Replacement Schedule

1 per Month

2 per Month

2 Sets per Month

Every 3 Months

Every 3 Months

Every 6 Months

Every 6 Months

Every 6 Months

Every 6 Months

 

 

Call American HomePatient at 1-877-247-2285 or submit your CPAP order information online.

Call us or submit your information online.

American HomePatient gathers all the necessary documentation from your doctor, including Rx information to make the CPAP supplies reorder process as easy as possible.

We gather all the necessary documentation from your doctor, including Rx* information.

American HomePatient works with your insurance company to give you an estimate of coverage and out-of-pocket costs for CPAP supplies.

We work with your insurance company to give you an estimate of coverage and out-of-pocket costs.

American HomePatient ships your order free of charge, wherever you want.

Your order is shipped to you free of charge.

American HomePatient provides ongoing, premium life support.

We provide ongoing, premium life support.

Rx* information is required by law regardless of where you purchase.

 

Completing this form does not constitute an order.

Print and complete our Assignment of Benefits form.

*American HomePatient must verify insurance coverage of any item(s) ordered before shipping to patients.