Re-Order your CPAP supplies online. Now Available! - see link below:
For new referrals, Please use the forms below and fax to (808) 261-8896. If you have any questions, please call during business hours and we can assist
Standard CPAP/BILEVEL order form and checklist
BiPAP ST or ASV order form (Bilevel with RATE)
To expedite the process for your Re-Supply Transfer patients, Please advise the patient to download this form and be ready to provide to P.I.M.