If you have coverage through your employer or plan sponsor, use our workplace benefits insurance forms. If you have coverage through an advisor, use our personal insurance forms.  

If you have coverage through your employer, use this form to request a Positive Airway Pressure (PAP) System device. You'll find instructions on how to return the completed form on the form itself.

Download this form and print it, or fill it out in Adobe Reader XI or higherOpens a new website in a new window (not your browser) and save.