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CPAP/BiPAP Extended Warranty Claim

Patient Information

First name *

Last name *

Date of birth *

Phone number *

Email address *

Device brand *

Device model *

Serial number *

Date device was received *

Did you purchase an extended warranty? *

Issue type *

Describe the issue *

Has the device had internal water exposure? *

Does the device have physical damage? *

Upload photos of your device *

Images only. Include the serial number label.

I understand claim approval is subject to the terms of my extended warranty coverage *

I confirm the information provided is accurate *

Your information is sent securely to Medigy and used only to process this request. Questions? Contact us.