CPAP/BiPAP Referrals:

Please use this referral CHECKLIST as a fax cover sheet, and our staff will address it immediately. Please fax to (808) 261-8896

When we receive all of the documents required by your patient's insurer, we can immediately process the order. 

You can use this as an order form or send your own form or prescription

If we do not receive all documents, there will be delays in processing 

Pacific Island Medical is a locally owned and operated respiratory home equipment vendor. We have provided medical equipment and supplies to the people of Hawai'i for the past 30 years with an emphasis on knowledgeable, professional, and friendly service.

Our experience, personalized service, and helpful, local staff makes us the premier provider of CPAP and respiratory equipment in the Islands.