Afflovest Order Form. Send us your information and a representative will reach out as soon. Afflovest provides the treatment for copd, bronchiectasis.
Afflovest Atlantic Respiratory Services
* afflovest requires a doctor’s prescription for treatment by high frequency chest wall oscillation (hfcwo). Web standard written order: Afflovest requires a doctor’s prescription for treatment by high frequency chest wall oscillation (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. Web the afflovest requires a doctor’s prescription for treatment by hfcwo. Send us your information and a representative will reach out as soon. The afflovest has received the fda’s 510k clearance for u.s. 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. Physician signature (no signature stamp) date 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. 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 request more information about afflovest. Market availability, and is approved for medicare, medicaid, and private health insurance reimbursement. Web standard written 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. Afflovest requires a doctor’s prescription for treatment by high frequency chest wall oscillation (hfcwo). Physician signature (no signature stamp) date Web physicians order that includes: Leaving blank presumes lifetime (99 months) 3. * afflovest requires a doctor’s prescription for treatment by high frequency chest wall oscillation (hfcwo).
