Apria cpap order form 2026

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The document is a Respiratory/Sleep Therapy Order Form used by healthcare providers to request oxygen therapy, nebulizers, and sleep therapy equipment for patients. It includes sections for patient demographics, diagnosis codes, oxygen needs, overnight oximetry testing, and sleep therapy specifications. The form requires signatures and documentation to support the medical necessity of the prescribed items.

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Click ‘Get Form’ to open the Apria CPAP order form in the editor.
Begin by filling in your Apria representative's name and branch location at the top of the form. This information is essential for processing your order.
In the 'Referral Source' section, provide the office name, contact name, and relevant dates along with phone and fax numbers to ensure clear communication.
Complete the 'Patient Information' section by entering the patient's full name, date of birth, and contact numbers. Make sure to include diagnosis codes from the provided list.
Specify oxygen needs by indicating estimated length of need, test dates, and delivery routes. Fill in qualifying SAT results as required.
For sleep therapy details, indicate CPAP settings and mask preferences. Ensure all necessary documentation is attached as specified in each section.
Finally, have the prescriber sign and date the document to authorize its use as a dispensing prescription.

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Got questions?

We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

How do I order CPAP?

You can buy a CPAP machine through your healthcare provider and insurance coverage or from an online store like Sleep Doctor. A CPAP prescription is necessary for purchase in both cases.

Can I order my own CPAP machine?

Whether you buy online or in-store, you must present a prescription to purchase a CPAP machine or a mask. When buying online, the retailer should include a step during the checkout process where you can email or upload a copy of your prescription.

What is needed for a CPAP order?

The required documents include medical records from your doctors visit, sleep study results, a prescription from your healthcare provider and completed insurance form, as required. After the start of therapy, your usage of the device may be assessed to ensure continued coverage.

How to reorder CPAP supplies from Apria?

Dial 800-436-5657 to use Aprias convenient, automated phone system and follow the prompts to place your order. Available 24 hours a day.

Can I order Apria CPAP supplies online?

Apria.com. If you are currently receiving sleep therapy supplies from Apria, you can log on to the companys PAP Patient Resupply Portal and place an order for sleep supplies. The benefit of using this site is that Apria will directly bill your insurance for you. To register, go to: .apria.com/papresupply.

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