Afflovest Order Form

About AffloVest Mobile HFCWO Vest Therapy Afflovest

Afflovest Order Form. Send us your information and a representative will reach out as soon. 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.

About AffloVest Mobile HFCWO Vest Therapy Afflovest
About AffloVest Mobile HFCWO Vest Therapy Afflovest

Please answer all questions to the best of your ability so we can provide you with the most comprehensive information about afflovest. Physician signature (no signature stamp) date 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. Market availability, and is approved for medicare, medicaid, and private health insurance reimbursement. * afflovest requires a doctor’s prescription for treatment by high frequency chest wall oscillation (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. Web standard written order: Web physicians order that includes: The afflovest has received the fda’s 510k clearance for u.s. Fill out the form below to receive emails and literature in the mail containing more information about afflovest mobile mechanical hfcwo airway clearance therapy.

Afflovest provides the treatment for copd, bronchiectasis. 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. Leaving blank presumes lifetime (99 months) 3. Web the afflovest requires a doctor’s prescription for treatment by hfcwo. Web physicians order that includes: Web standard written order: Web request more information about afflovest. 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. 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. Physician signature (no signature stamp) date Fill out the form below to receive emails and literature in the mail containing more information about afflovest mobile mechanical hfcwo airway clearance therapy.