Afflovest Order Form. Web request more information about afflovest. Web standard written order:
AffloVest Absolute Respiratory Care
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. Physician signature (no signature stamp) date 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. Leaving blank presumes lifetime (99 months) 3. Afflovest provides the treatment for copd, bronchiectasis. Send us your information and a representative will reach out as soon. Web request more information about afflovest. The afflovest has received the fda’s 510k clearance for u.s. * afflovest requires a doctor’s prescription for treatment by high frequency chest wall oscillation (hfcwo). Web standard written order:
Web physicians order that includes: 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. Please answer all questions to the best of your ability so we can provide you with the most comprehensive information about afflovest. Afflovest provides the treatment for copd, bronchiectasis. Afflovest requires a doctor’s prescription for treatment by high frequency chest wall oscillation (hfcwo). Web standard written order: 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. The afflovest has received the fda’s 510k clearance for u.s. 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. Leaving blank presumes lifetime (99 months) 3.
