Afflovest Order Form. Web the afflovest requires a doctor’s prescription for treatment by hfcwo. Find out how afflovest, the first portable, fully mobile during use hfcwo vest, can help patients with cystic fibrosis clear their airways and mobilize lung secretions.
Afflovest Atlantic Respiratory Services
Send us your information and a representative will reach out as soon. Web the afflovest requires a doctor’s prescription for treatment by hfcwo. Fill out the form below to receive emails and literature in the mail containing more information about afflovest mobile mechanical hfcwo airway clearance therapy. Physician signature (no signature stamp) date Web by providing this form to an authorized afflovest distributor, i acknowledge that the patient is aware that he or she may be contacted by said distributor for any additional information to process this order. Find out how afflovest, the first portable, fully mobile during use hfcwo vest, can help patients with cystic fibrosis clear their airways and mobilize lung secretions. The afflovest has received the fda’s 510k clearance for u.s. Market availability, and is approved for medicare, medicaid, and private health insurance reimbursement. Web this form to an authorized afflovest distributor, i acknowledge that the patient is aware that he or she may be contacted by said distributor for any additional information to process this order. * afflovest requires a doctor’s prescription for treatment by high frequency chest wall oscillation (hfcwo).
Please answer all questions to the best of your ability so we can provide you with the most comprehensive information about afflovest. Market availability, and is approved for medicare, medicaid, and private health insurance reimbursement. Send us your information and a representative will reach out as soon. Please answer all questions to the best of your ability so we can provide you with the most comprehensive information about afflovest. Web physicians order that includes: Fill out the form below to receive emails and literature in the mail containing more information about afflovest mobile mechanical hfcwo airway clearance therapy. Web standard written order: Afflovest requires a doctor’s prescription for treatment by high frequency chest wall oscillation (hfcwo). Web this form to an authorized afflovest distributor, i acknowledge that the patient is aware that he or she may be contacted by said distributor for any additional information to process this order. Web by providing this form to an authorized afflovest distributor, i acknowledge that the patient is aware that he or she may be contacted by said distributor for any additional information to process this order. Once your healthcare team has decided afflovest is the airway clearance therapy for you, they can fill out the afflovest order form, provide all necessary insurance and medical documentation and contact a dme distributor to place the afflovest order.
