CALL US (800) 273-9114
Fax: (877) 339-0180
Tax ID: 45-0510425
14-Replacement Supplies Page - Delivery Guy

Replacement
Supplies
Delivered to
Your Door

Call Optigen today at 800-273-9114 to place your order for your CPAP supplies or request supplies online using the form to the right.

Replacement Supplies

If you have had your mask, tubing, and filters for 3 months or longer, Optigen can provide you with new PAP supplies at little or no cost, with free delivery directly to your home. Optigen stocks all of the most popular mask types and sizes as well as the other supplies you may need such as tubing, filters, cushions and headgear. 
You can even schedule an in-home appointment with our professional PAP mask fitting specialist to ensure you are using the most comfortable CPAP mask for you. Check out our products! 
*If you have had your machine for 5 years or longer, or your current machine is not download capable, you may be eligible for a new machine. 
 

Order Supplies Today!

Please fill out the secure form to the right. We will confirm your eligibility and we will request a prescription from your doctor on your behalf. 
Please Note: Having complete information will allow us to quickly request a prescription from your physician and will expedite the delivery of your supplies. If you already have a prescription, please fax it to us at 877-339-0180. If you would rather have us call you, please click here.

Supplies Reorder Form

Personal Information
First Name  *
Last Name  *
Street Address
City
State
ZIP
Phone
Secondary Phone
Email  *
Date of Birth
Date Format: 12/12/1990
Insurance Information
Primary Insurance Provider
Sponsor ID
Is the patient also the policy holder?
Physician Information
Physician Name
Physician Phone
Supplies Information
Do you currently receive supplies from another company?
Current Mask
Current Machine
Additional Supplies
By submitting this information, I authorize Optigen to contact me by phone or email.
 
  Please enter in the number below: