Support

Prescription Refresh Request

If an out-of-date prescription is holding up your supplies, ask about a telehealth visit with Medigy’s board-certified doctor. Existing Medigy patients and PAP users new to Medigy can request a review.

Patient Information

First name *

Last name *

Date of birth *

Phone number *

By providing your number, you agree Medigy may call or text you about your request. Message and data rates may apply.

Email address *

Your Prescription and Therapy

Have you received a device or supplies from Medigy before? *

Which state will you be in for a telehealth visit? *

This helps our team coordinate the visit. Let us know if your plans change.

What do you need help with? *

Are you currently using PAP therapy? *

When did you last see a provider about your sleep therapy?

An estimate is fine.

Current or most recent sleep / prescribing provider (if known)

Provider’s office phone (optional)

Photo of your current prescription (optional)

If you have it handy, you can attach a clear photo. You can still send your request without it.

Insurance

Are you new to Medigy, or has your insurance changed? *

If Medigy already has your current insurance, you won’t need to re-enter it here.

Anything Else

What would you like our team to know? (optional)

Tell us which supplies you need or what is holding up your resupply.

Acknowledgement

I understand this request does not renew my prescription. Medigy’s doctor will review my clinical eligibility during a visit before deciding whether an updated prescription is appropriate. *

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