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 you can't find your prescription or need any help, give us a call at 866.414.9700.

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: 856.767.7151

Print your physician order form.

Your data is safe at The CPAP Shop. 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.