Fill out the form below to start the order process. If more information is required, an American HomePatient customer service agent will contact you within two business days. Or call 877-221-8763.
Call us or submit your information online.
We gather all the necessary documentation from your doctor, including Rx* information.
We work with your insurance company to give you an estimate of coverage and out-of-pocket costs.
Your order is shipped to you free of charge.
We provide ongoing, premium life support.
Rx* information is required by law regardless of where you purchase.
Completing this form does not constitute an order.
Print and complete our Assignment of Benefits form.
*American HomePatient must verify insurance coverage of any item(s) ordered before shipping to patients.