CAP Physician Application

You are a physician filling in the form for a CPAP machine on behalf of your patient.

AirSense10 CPAP.jpg.CROP .thumbnail.223X169

The ASAA’s CPAP Assistance Program (CAP) has provided over 7,500 CPAP equipment packages to patients in need over the last three years. It is our mission to help as many patients as possible get the treatment that they need.

No one should go untreated due to financial hardship or other issues.

If you need to mail in of fax in your application, click here

SleepApnea Logo reverse transparent 300

Join ASAA Now Join Us Form
Enter Email
Confirm Email
Enter Password
Confirm Password
By submitting this form and providing personal information, I agree that my data is saved and might be used by / American Sleep Apnea Association (ASAA) to contact me regarding programs and news by phone, email or newsletter. I can revoke consent any time as per ASAA's Privacy Policy.