HME DEALER FORMS

Dealer CPAP Traveler Form

Repair Authority's Dealer CPAP Traveler Form provides dealers with an easy and convenient way to track each patient-owned CPAP unit sent in for repair and ensure that it's returned with the proper patient. When this form is submitted, Repair Authority will provide one estimate with your dealer price and and an MSRP estimate that you can submit for reimbursement. Please complete one form per unit, print the PDF and enclose it when you send in your device.

Note: This form is for use by HME dealers sending in patient-owned CPAP repairs only. For all other equipment, use our Equipment Packing List.

Need help? Please contact us at 888.828.1872 or email us at info@repairauthority.com.