Protect your Health.

Routine replacement of your CPAP supplies helps prevent the spread of bacteria and viruses. Breathe easier knowing your CPAP mask, tubing, and other supplies are clean and germ-free. Ensure you are receiving the greatest benefit from your therapy, and protect your health by filling out the order form below.

Health Essentials will ship CPAP supplies directly to your home.

CPAP Supply Order Form

Your insurance provider may reimburse you for the cost of these items:*

Contact Info

Name * Address * City * State * Zip * Phone Area Code * E-mail address * If applicable, please provide the city and state of the Health Essentials location currently serving you. City * State: * Your subject Comments

Recommended Replacement Schedule

2 per Month -

Disposable Filter

2 Sets per Month -

Replaceable Pillow or Cushions

Every 3 Months

Mask Tubing

Every 6 Months

Chin Strap Headgear Disposable Heated Humidification chamber Non-disposable filter

I want to protect my health.

Please call me when it is time to replace my CPAP supplies.

 

 

 

Completing this form does not constitute an order.
A Health Essentials Representative will contact you within 2 business days regarding your comment.

Thank you! As an alternative to submitting an electronic message, you may contact us by phone, toll free, by calling: (417) 347-7400.

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