HME DEALER FORMS

Dealer CPAP Traveler Form

YOUR COMPLETED FORM HAS BEEN RECEIVED!

1. Shortly you will receive an email with a PDF of your submission. Please print the PDF to enclose with your unit.

2. If you are on a regular Repair Authority route, attach this form to the device and return it with your other equipment.

3. If you are shipping in: attach this form to the device and ship to:

Repair Authority Headquarters/Cleveland Service Center
21973 Commerce Parkway, Dock 4
Strongsville, OH 44149
Questions: info@repairauthority.com or 888.828.1872

Need to submit another CPAP Traveler Form? Click here to start another submission.