Request service

Tell us what you need

A licensed respiratory therapist will call you back, usually within one business day. It takes about two minutes.

Equipment problem right now? Call us at (682) 337-3253. In an emergency, call 911.

Thank you. We got your request.

A respiratory therapist will call you back, usually within one business day.

1We review your request and your equipment needs.
2A therapist calls you at the number you gave us, at the time you chose.
3We schedule your visit or video visit and talk with your doctor if needed.

Need help sooner? Call (682) 337-3253. In an emergency, call 911.

Back to home Request an online account (optional)

Who is this for? Myself (the patient) Someone I care for

Your name

Phone

Email (optional)

ZIP code

Best time to call

What do you need help with? CPAP or BiPAP Home oxygen Home ventilator Nebulizer or aerosol therapy Airway clearance COPD or asthma care Telehealth visit Not sure yet

Smoking and oxygen safety (optional)

Does anyone smoke or vape in the home? This matters for oxygen fire safety.

Does the patient use tobacco or vape products?

These answers help the therapist plan safe, personalized care. They are optional, and you can choose "Prefer to discuss by phone."

Is this new equipment or a problem with equipment you already have?

How do you plan to pay for your care? I have insurance I plan to pay out of pocket (self-pay) I'm not sure yet. I'd like to talk about it.

What type of insurance do you have? (optional)

This will not stop us from helping you. We'll go over your options when we call. Please don't enter your member ID here. Insurance information

This is an urgent equipment problem

Your doctor's name (optional)

Leave this empty

Please don't type diagnoses, medications or other health details in the form. The few health questions above are optional and are sent to us by email, which is not fully private. We'll go over health details when we call.

I agree that Respirago may call or email me about this request. I have read the privacy policy and Notice of Privacy Practices.