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.

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.

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

Print your physician order form.

Your data is safe at AdaptHealth Marketplace. The online form is hosted by our HIPAA compliance partner MDOfficeMail. If you choose to submit by the online form you will be redirected to the MD Office Mail website where your submission will be encrypted.