Fisher & Paykel Forma CPAP Mask Headgear

RX Required

To purchase 'RX Required' products, your prescription must include:

• Physician's contact information
• Physician's signature
• Patient's full name
• Prescription date within the past 365 days

Additional requirements may apply depending on your purchase:

CPAP/APAP Machine:

• Diagnosis
• Single pressure setting (CPAP) or pressure range (APAP)
• Inclusion of humidifier, if applicable
• Mask/delivery system preference, if applicable

CPAP Equipment:

• A statement of "CPAP equipment" or "CPAP supplies"

FSA/HSA Eligible

• You can use your HSA and FSA debit cards for payments.
• Please check with your health benefits administrator to confirm eligibility.
• Note that we can't split payments between these cards and major credit cards or between eligible and non-eligible products. You'll need to make separate transactions.
• Payment options at SHOPRotech include Visa, Mastercard, Discover, American Express, and HSA/FSA debit cards.