Submit a prescription
Submit an Rx for portable or stationary oxygen
If you're a physician, you may submit a prescription for a patient via our HIPAA-compliant online form portal"ONLINE RX FORM" or fax 800-418-6998 . We also provide a"PDF RX FORM" for physicans and clients to print out, this has the required and recommended information for precribing medical oxygen. Or call 1-833-360-2155
If you're a client that has your prescription, submit your prescription through the client prescription form.
Need help?
