Positive Airway Pressure (PAP) Machine request form
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Request a Positive Airway Pressure (PAP) Machine Assessment
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 - Opens in a new window (not your browser) and save.
Use this form to request coverage for a positive airway pressure machine. You’ll need the doctor to fill it out.