CPAP Fulfillment

Recommended Replacement Schedule

Schedule	Item	Quantity
2 Per Month	Displosable Filter
2 Sets Per Month	Replaceable Pillow or Cushions
Every 3 Months	Mask
Every 3 Months	Tubing
Every 6 Months	Chin Strap
Every 6 Months	Headgear
Every 6 Months	Humidification Chamber
Every 6 Months	Non-disposable Filter

Customer Information Full Name Street Address City State Zip Code Phone Email

Comments

Accreditation Commission for Health Care

Patients