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    Cardinal Sleep Prescription Request Form

    Prescriptions

    Federal law requires we have a valid prescription on file before shipping a mask, machine & humidifier.

    Please submit a prescription with a future expiration date, written for “lifetime need”, or “99 months”.

    As long as the prescription has these prerequisites, you can purchase CPAP equipment.

    If you are making the purchase of a prescription-required item without insurance, we still need a prescription to fulfill the order based on Federal regulations.

    CPAP Accessories and mask parts are the only equipment sold without without a prescription.

    Replacement Cycle

    Description Model Replace
    CPAP Mask A7034 Every 3 months
    CPAP headgear A7035 Every 3-6 months
    CPAP tubing A7037 Every 3 months
    Disposable filter A7038 2 every month
    Non-disposable fil. A7039 2 every 6 months
    CPAP chin strap A7036 Every 6 months
    Full Face mask A7030 Every 3 months
    Oral CPAP mask A7044 Every 3 months
    Humidifier chamber A7046 Every 6 months
    CPAP machine E0601 3-5 years as necessary

     

    Helpful Links

    Sleep Apnea Symptoms

    ResMed