Submit Your Prescription

If purchasing an FDA prescribed item such as a CPAP, VPAP or BiPAP/BiLevel machine, please use one of the secure methods below to submit your prescription.

If purchasing an FDA prescribed item such as a CPAP, VPAP or BiPAP/BiLevel machine, please use one of the secure methods below to submit your prescription.

Woman in bed stretches after a good night of sleep while still wearing her AirTouch F30i Comfort full face CPAP mask

Secure Form

To submit by the secure online form scan or take a photo of your prescription and submit the image and your order ID.

 Go to Secure Form

Secure Fax

To submit by the secure digital fax send to the fax number below. Please include your order number on the cover page.

FAX to: 856.302.9291