Paying a Fee for the Mask Program

Our Yearly Supply Program offers you an entire year’s worth of supplies:
4 masks, 2 tubes and 4 filters-all in one shipment.

Please make your online online application here, and make the payment on the form to the right. Please don’t forget to let us know the name of the Patient receiving the mask(s).

You can choose between paying with your credit card or Paying with Paypal.

Program Fee and prescription must be received prior to shipping.