Distributors Order Form

Place orders for 20+ units

ResPlus Auto CPAP Machine

Included: Auto CPAP, Heated Humidifier, power supply, carry bag, 5 ft tubing, SD card

Product ID: #9000-1

Price: $195.00

    Number of Units Requested (minimum 20 units, multiples of 2)

    Order Amount (Excluding shipping and processing charges)

    NPI #

    Dealer’s Name

    Dealer’s Address

    Email address



    Ship To Address

    Contact Information

    Purchase Order #

    Order Date

    Requested Shipping Date

    Important: Once you have submitted your order we will calculate the freight and send you an invoice for Total amount. We will alert you 48 hours prior to shipment and require prepayment before releasing Your order. You will be able to pay on the website via CC with a link that will be provided.